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Gritti V, Pierini S, Ferlini M, Mauri S, Barbieri L, Castiglioni B, Lettieri C, Mircoli L, Mortara A, Nassiacos D, Oltrona Visconti L, Paggi A, Soriano F, Sponzilli C, Corsini A. Atrial fibrillation and ischemic heart disease: (un)solved therapeutic dilemma? Minerva Cardiol Angiol 2024; 72:225-236. [PMID: 37870421 DOI: 10.23736/s2724-5683.23.06275-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
Concomitant presence of atrial fibrillation and coronary artery disease requiring percutaneous coronary intervention is a frequent occurrence. The choice of optimal antithrombotic therapy, in this context, is still challenging. To offer the best protection both in terms of stroke and stent thrombosis, triple therapy with oral anticoagulation and dual antiplatelet therapy would be required. Several drug combinations have been tested in recent years, including direct oral anticoagulants, with the aim of balancing ischemic and bleeding risk. Both pharmacokinetic aspects of the molecules and patient's characteristics should be analyzed in choosing oral anticoagulation. Then, as suggested by guidelines, triple therapy should start with a seven-day duration and the aim to prolong to thirty days in high thrombotic risk patients. Dual therapy should follow to reach twelve months after coronary intervention. Even not fully discussed by the guidelines, in order to balance ischemic and bleeding risk it should also be considered: 1) integrated assessment of coronary artery disease and procedural complexity of coronary intervention; 2) appropriateness to maintain the anticoagulant drug dosage indicated in technical data sheet; the lack of data on the suspension of antiplatelet drugs one year after percutaneous intervention; 3) the possibility of combination therapy with ticagrelor; and 4) the need to treat the occurrence of paroxysmal atrial fibrillation during acute coronary syndrome. With data provided clinician should pursue a therapy as personalized as possible, both in terms of drug choice and treatment duration, in order to balance ischemic and bleeding risk.
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Affiliation(s)
- Valeria Gritti
- Division of Cardiology, Foundation IRCCS Polyclinic San Matteo, Pavia, Italy -
| | - Simona Pierini
- Unit of Cardiology and Cardiac Intensive Care, ASST Nord Milano, Sesto San Giovanni, Milan, Italy
| | - Marco Ferlini
- Division of Cardiology, Foundation IRCCS Polyclinic San Matteo, Pavia, Italy
| | - Silvia Mauri
- Cardiology and Coronary Unit, ASST Ovest Milanese, Milan, Italy
| | - Lucia Barbieri
- Unit of Cardiology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | - Luca Mircoli
- Unit of Cardiology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Mortara
- Department of Clinical Cardiology, Polyclinic of Monza, Monza, Monza-Brianza, Italy
| | - Daniele Nassiacos
- Unit of Cardiology and Cardiac Intensive Care, ASST Valle Olona, Saronno, Varese, Italy
| | | | - Anita Paggi
- Unit of Cardiology and Cardiac Intensive Care, ASST Nord Milano, Sesto San Giovanni, Milan, Italy
| | - Francesco Soriano
- Cardiothoracovascular Department, ASST Niguarda Hospital, Milan, Italy
| | | | - Alberto Corsini
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
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2
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Oliva F, Boriani G, Calabrò P, Caldarola P, Carugo S, Castiglioni B, Celentani D, Comeglio M, De Luca L, De Maria R, Di Muro M, Ignone G, Leonardo F, Margonato A, Massari F, Murrone A, Nardi F, Patti G, Perna G, Pinna P, Poli M, Prati F, Raddino R, Pierdomenico SD, Tammaro P, Porto I. [Optimizing the care management pathway of patients with ischemia and non-obstructive coronary arteries]. G Ital Cardiol (Rome) 2024; 25:309-317. [PMID: 38639121 DOI: 10.1714/4252.42294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Ischemia with non-obstructive coronary arteries (INOCA) is defined by the coexistence of anginal symptoms and demonstrable ischemia, with no evidence of obstructive coronary arteries. The underlying mechanism of INOCA is coronary microvascular dysfunction with or without associated vasospasm. INOCA patients have recurrent symptoms, functional limitations, repeated access to the emergency department, impaired quality of life and a higher incidence of cardiovascular events than the general population. Although well described in chronic coronary syndrome guidelines, INOCA remains underdiagnosed in clinical practice because of insufficient awareness, lack of accurate diagnostic tools, and poorly standardized and consistent definitions to diagnose, both invasively and non-invasively, coronary microvascular dysfunction.To disseminate current scientific evidence on INOCA as a distinct clinical entity, during 2022 we conducted at 30 cardiology units all over the country a clinical practice improvement initiative, with the aim of developing uniform and shared management pathways for INOCA patients across different operational settings. The present document highlights the outcomes of this multidisciplinary initiative.
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Affiliation(s)
- Fabrizio Oliva
- Cardiologia 1-Emodinamica, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Giuseppe Boriani
- Cardiologia, Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Università degli Studi di Modena e Reggio Emilia, Policlinico di Modena, Modena
| | - Paolo Calabrò
- U.O.C. Cardiologia Clinica a Direzione Universitaria, A.O.R.N. Sant'Anna e San Sebastiano, Caserta
| | | | - Stefano Carugo
- Dipartimento Area Cardio-Toraco-Vascolare, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano
| | | | | | | | - Leonardo De Luca
- S.C. Cardiologia, Fondazione IRCCS Policlinico San Matteo, Pavia
| | - Renata De Maria
- SSD Diagnosi e Cure Territoriali Malattie Cardiache e Centro Clinico Dislipidemie Grossi Paoletti, Dipartimento CardioToracoVascolare, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Michele Di Muro
- Cardiologia Interventistica, Dipartimento Cardiotoracico e Vascolare, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | | | | | | | - Francesco Massari
- U.O. Cardiologia, Ospedale della Murgia "Fabio Perinei", Altamura (BA)
| | - Adriano Murrone
- U.O.C. Cardiologia-UTIC, P.O. Alto Tevere - Ospedale di Città di Castello (PG)
| | - Federico Nardi
- U.O. Cardiologia, Ospedale Santo Spirito, Casale Monferrato (AL)
| | - Giuseppe Patti
- U.O. Cardiologia, Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara
| | - Gianpiero Perna
- U.O. Cardiologia, Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona
| | - Paolo Pinna
- U.O. Medicina d'Urgenza, Azienda Ospedaliera Universitaria di Sassari
| | - Marco Poli
- Cardiologia-UTIC, Ospedale Sandro Pertini, ASL Roma 2, Roma
| | - Francesco Prati
- Dipartimento Cardiovascolare, Azienda Ospedaliera San Giovanni Addolorata, Roma
| | | | - Sante Donato Pierdomenico
- Medicina Interna, Dipartimento di Tecnologie Innovative in Medicina & Odontoiatria, Università degli Studi "G. d'Annunzio" - Chieti-Pescara, Chieti
| | - Paolo Tammaro
- Cardiologia-UTIC, Ospedale San Giovanni Bosco - ASL Napoli 1 Centro, Napoli
| | - Italo Porto
- Malattie Cardiovascolari, IRCCS Ospedale Policlinico San Martino, Genova
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3
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Ferlini M, Munafò A, Varbella F, Delnevo F, Solli M, Trabattoni D, Piccaluga E, Cardile A, Canova P, Rossini R, Celentani D, Ugo F, Taglialatela V, Airoldi F, Rognoni A, Oliva F, Porto I, Carugo S, Castiglioni B, Lettieri C, Chinaglia A, Currao A, Patti G, Oltrona Visconti L, Musumeci G. Achievement of target LDL-cholesterol level in patients with acute coronary syndrome undergoing percutaneous coronary intervention: The JET-LDL registry. Int J Cardiol 2024; 397:131659. [PMID: 38101704 DOI: 10.1016/j.ijcard.2023.131659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 11/28/2023] [Accepted: 12/10/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND In patients with acute coronary syndromes (ACS), current guidelines recommend a low-density lipoprotein cholesterol (LDL-C) level < 1.4 mmol/L (<55 mg/dL). METHODS The JET-LDL is a multicenter, observational, prospective registry created to investigate levels of LDL-C in consecutive patients with ACS undergoing PCI at 35 Italian hospitals, and to report their lipid lowering therapies (LLT). Follow-up was planned at 1 and 3 months. LDL-C reduction >50% from baseline or level < 55 mg/dL at 1-month was the primary endpoint. RESULTS A total of 1095 patients were included: median age was 67 (58-75); 33.7% were already on LLT. Baseline LDL-C levels was 105 (76.5-137) mg/dL. At hospital discharge all patients were on LLT: 98.1% received statins (as mono or combination therapy), ezetimibe and PCSK9i were used in 60.1% and 8.5% of cases, respectively. Primary endpoint was achieved in 62% (95% CI 58-65) of cases. At 1-month LDL-C levels dropped to 53 (38-70) mg/dL (p < 0.001 vs baseline) and it was <55 mg/dL in 53% (95% CI 49-57) of patients; however, PCSK9i were added to 7 further cases. At 3-months 58% (95% CI 55-62) of patients achieved the target level, but PCSK9i was added to only 11 new patients. CONCLUSIONS In this real-world registry of ACS patients undergoing PCI, recommend LDL-C levels were obtained in 62% of patients, but PCSK9i prescription was limited to 10% of cases. As LLT pattern appeared mainly improved at hospital discharge, an early and strong treatment should be considered.
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Affiliation(s)
- Marco Ferlini
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - Andrea Munafò
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | | | - Fabrizio Delnevo
- Cardiologia, Azienda Ospedaliera Ordine Mauriziano, Torino, Italy
| | - Martina Solli
- Università del Piemonte Orientale, Cardiologia, AOU Maggiore della Carità di Novara, Italy
| | - Daniela Trabattoni
- Interventional Cardiology Dept., Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - Emanuela Piccaluga
- Cardiologia 1, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Antonino Cardile
- SC Cardiologia, ASST Bergamo Ovest - Ospedale Treviglio, Treviglio (BG), Italy
| | - Paolo Canova
- SC Cardiologia, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | | | | | - Fabrizio Ugo
- SC Cardiologia, Ospedale Sant'Andrea di Vercelli, Italy
| | | | - Falvio Airoldi
- SC Cardiologia, I.R.C.C.S. MultiMedica di Sesto San Giovanni, Italy
| | | | - Fabrizio Oliva
- Cardiologia 1, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Italo Porto
- SC Cardiologia, Ospedale San Martino Genova, Università degli studi di Genova, Italy
| | - Stefano Carugo
- Department of Clinical Sciences and Community Health, University of Milano, Italy, Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Italy
| | | | - Corrado Lettieri
- SC Cardiologia, ASST Mantova, Ospedale Carlo Poma di Mantova, Italy
| | | | - Alessia Currao
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Giuseppe Patti
- Università del Piemonte Orientale, Cardiologia, AOU Maggiore della Carità di Novara, Italy
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Fontana F, Piacentino F, Gnesutta A, Macchi E, Coppola A, Saccomanno A, Gatta T, Recaldini C, Minenna M, Tamborini C, Dossi F, Ascenti V, Barbera S, Cicero G, Carcano G, Ascenti G, Castiglioni B, Venturini M. Transcatheter Aortic Valve Implantation (TAVI) Planning with Dual-Layer Spectral CT Using Virtual Monoenergetic Image (VMI) Reconstructions and 20 mL of Contrast Media. J Clin Med 2024; 13:524. [PMID: 38256659 PMCID: PMC10816911 DOI: 10.3390/jcm13020524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/13/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024] Open
Abstract
Transcatheter aortic valve implantation (TAVI) is a less invasive alternative to surgical implantation and its implementation is progressively increasing worldwide. We routinely perform pre-procedural aortic angiography CT to assess aortic dimensions and vascular anatomy. This study aims to evaluate the image quality of CTA for TAVI planning using dual-layer spectral CT, with virtual monoenergetic image reconstructions at 40 keV. Thirty-one patients underwent a CTA protocol with the injection of 20 mL of contrast media. Image quality was assessed by measuring the mean density in Hounsfield Units (HU), the signal-to-noise ratio, and the contrast-to-noise ratio in VMI reconstructions. Additionally, a blinded subjective analysis was conducted by two observers. The results showed significant enhancement at all sampled vascular levels with a gradual decrease in HU from proximal to distal regions. Favourable subjective ratings were given for all parameters, with greater variability in the evaluation of iliac axes. A significant negative correlation (p < 0.05) was observed between BMI and CA at all vascular levels, indicating reduced contrast enhancement with increasing BMI. Spectral CT, along with reducing iodine load, allows for obtaining high-quality images without a significant increase in noise. The reduction in iodine load can have positive implications in clinical practice, improving patient safety and resource efficiency.
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Affiliation(s)
- Federico Fontana
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
- Postgraduate School of Radiology Technician, Insubria University, 21100 Varese, Italy;
| | - Filippo Piacentino
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
| | - Aroa Gnesutta
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
| | - Edoardo Macchi
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
| | - Andrea Coppola
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
| | - Angiola Saccomanno
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
| | - Tonia Gatta
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
| | - Chiara Recaldini
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
| | - Manuela Minenna
- Postgraduate School of Radiology Technician, Insubria University, 21100 Varese, Italy;
| | - Claudio Tamborini
- Department of Cardiovascular Diseases, ASST Settelaghi, 21100 Varese, Italy; (C.T.); (F.D.); (B.C.)
| | - Filippo Dossi
- Department of Cardiovascular Diseases, ASST Settelaghi, 21100 Varese, Italy; (C.T.); (F.D.); (B.C.)
| | - Velio Ascenti
- Postgraduate School of Radiodiagnostics, Policlinico Universitario, University of Milan, 20133 Milano, Italy;
| | - Simone Barbera
- Diagnostic and Interventional Radiology Unit, Biomorf Department, University Hospital Messina, 98124 Messina, Italy; (S.B.); (G.C.); (G.A.)
| | - Giuseppe Cicero
- Diagnostic and Interventional Radiology Unit, Biomorf Department, University Hospital Messina, 98124 Messina, Italy; (S.B.); (G.C.); (G.A.)
| | - Giulio Carcano
- Department of Medicine and Technological Innovation, Insubria University, 21100 Varese, Italy;
| | - Giorgio Ascenti
- Diagnostic and Interventional Radiology Unit, Biomorf Department, University Hospital Messina, 98124 Messina, Italy; (S.B.); (G.C.); (G.A.)
| | - Battistina Castiglioni
- Department of Cardiovascular Diseases, ASST Settelaghi, 21100 Varese, Italy; (C.T.); (F.D.); (B.C.)
| | - Massimo Venturini
- Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
- Department of Medicine and Technological Innovation, Insubria University, 21100 Varese, Italy;
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Demola P, Beneduce A, Masiero G, Serino F, Baldi E, Polimeni A, Attisano T, Contarini M, Castiglioni B, De Marco F, Fineschi M, Menozzi A, Musto C, Tarantini G, Saia F, Esposito G. [Management of patients with myocardial ischemia/infarction with non-obstructive coronary artery disease in Italian catheterization laboratories: results of the SICI-GISE national survey promoted by the GISE Young Committee]. G Ital Cardiol (Rome) 2023; 24:42S-52S. [PMID: 37767847 DOI: 10.1714/4101.40994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
BACKGROUND Myocardial ischemia (INOCA) and acute myocardial infarction with non-obstructive coronary artery disease (MINOCA) represent emerging entities in the landscape of interventional cardiology. These conditions have heterogeneous pathophysiological mechanisms and clinical presentations, complex diagnostics, and high prognostic significance. METHODS This survey was carried out jointly by the GISE Young Committee with the support of the SICI-GISE Society and the ICOT group with the aim of evaluating the implementation of diagnostic-therapeutic pathways in cases of suspected/confirmed INOCA and MINOCA diseases. A web-based questionnaire based on 22 questions was distributed to SICI-GISE and ICOT members. RESULTS The survey was distributed to 1550 physicians with 104 (7%) responses. The majority of participants included interventional cardiologists (70%), in two-thirds of cases working in centers with high volume of procedures (>1000 coronary angiographies/year), who estimated a <10% annual rate of INOCA and MINOCA cases in their case load. Approximately 25% of the participants stated that they do not have the option of performing any investigation for the evaluation of patients with suspected INOCA, and less than 50% make use of advanced invasive testing for the diagnosis of MINOCA, including physiology and intravascular imaging tests. It also turns out that about 50% of respondents reported the present and future absence of dedicated diagnostic-therapeutic pathways. Even with a high perception of the clinical relevance of these diseases, about 40% of the respondents rely on clinical experience or do not deal with their management, also reporting a low prevalence of dedicated follow-up care (20% of cases followed at dedicated outpatient clinics). Factors predominantly limiting the prevalence of appropriate diagnostic and treatment pathways included the cost of materials, lack of training and expertise of practitioners, and of solid data on the long-term clinical efficacy of treatments. CONCLUSIONS Currently, the proper management of INOCA and MINOCA disease is widely advocated but poorly implemented in clinical practice. To reverse the trend and solve the remaining controversies, it is necessary to enhance awareness, produce robust scientific data, and implement dedicated pathways for patients.
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Affiliation(s)
| | | | - Giulia Masiero
- Dipartimento di Scienze Cardio-Toraco-Vascolari e Sanità Pubblica, Università degli Studi, Padova
| | - Federica Serino
- Divisione di Cardiologia, A.O.R.N. Antonio Cardarelli, Napoli
| | - Enrico Baldi
- Divisione di Cardiologia, Fondazione IRCCS Policlinico San Matteo, Pavia
| | - Alberto Polimeni
- Dipartimento di Farmacia e Scienze della Salute e della Nutrizione, Università della Calabria, Rende (CS)
| | - Tiziana Attisano
- Divisione di Cardiologia Interventistica, Dipartimento Cardiotoracovascolare, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | - Marco Contarini
- U.O. Cardiologia con UTIC ed Emodinamica, Presidio Ospedaliero Umberto I, Siracusa
| | | | - Federico De Marco
- U.O. Cardiologia Interventistica Valvolare e Strutturale, Centro Cardiologico Monzino, Milano
| | - Massimo Fineschi
- U.O.S.A. Cardiologia Interventistica, Azienda Ospedaliera Universitaria Senese, Siena
| | - Alberto Menozzi
- S.C. Cardiologia, Ospedale Sant'Andrea, ASL5 Liguria, La Spezia
| | - Carmine Musto
- Divisione di Cardiologia, Azienda Ospedaliera San Camillo, Roma
| | - Giuseppe Tarantini
- Dipartimento di Scienze Cardio-Toraco-Vascolari e Sanità Pubblica, Università degli Studi, Padova
| | - Francesco Saia
- Alma Mater Studiorum, Università degli Studi di Bologna e IRCCS Policlinico Sant'Orsola, Bologna
| | - Giovanni Esposito
- Dipartimento di Scienze Biomediche Avanzate, Università di Napoli "Federico II", Napoli
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6
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Gioia G, Severgnini M, Cremonesi P, Castiglioni B, Freeman J, Sipka A, Santisteban C, Wieland M, Gallardo VA, Scott JG, Moroni P, Addis MF. Genomic Characterization of Mycoplasma arginini Isolated from a Housefly on a Dairy Farm and Comparison with Isolates from Bovine Milk and Lung Tissue. Microbiol Spectr 2023; 11:e0301022. [PMID: 37199649 PMCID: PMC10269790 DOI: 10.1128/spectrum.03010-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 04/17/2023] [Indexed: 05/19/2023] Open
Abstract
Mycoplasma mastitis can be highly contagious, unresponsive to treatment, and cause severe economic problems in affected herds. Notable routes of Mycoplasma spp. transmissions are contaminated milking equipment and animal contact through respiratory secretions. Only a few studies report the environment as a possible source of infection. Our group studied the presence of pathogens in houseflies (Musca domestica) in a New York State dairy in the United States. Among others, a Mycoplasma spp. was found in the gut of a housefly captured in the sick pen and identified as M. arginini. Here, we characterized its genome and investigated its relatedness with eight isolates from milk, one isolate from lung tissue collected in the same dairy, and five other dairies in New York State. We applied whole-genome sequencing and phylogenetic analysis based on the sequences of the 16S rRNA gene and 76 conserved proteins. We also assessed an in silico virulence profile by considering a panel of 94 putative virulence genes. As a result of the genome analysis, the housefly M. arginini isolate was highly similar to the milk isolates; interestingly, the similarity was highest with M. arginini isolated from milk on the same dairy farm where the housefly was captured. The housefly and milk M. arginini isolates possessed 54 of the 94 pathogenicity genes considered. Our data support the hypothesis that houseflies are carriers of Mycoplasma spp. and can be considered within the possible roots of environmental transmission of infection in dairy cows. Nevertheless, M. arginini pathogenicity will need to be investigated with dedicated studies. IMPORTANCE It is critical to control the spread of bovine mastitis caused by Mycoplasma spp., as this disease can be highly contagious and have a severe economic impact on affected dairies. A better understanding of possible transmission routes is crucial for infection control and prevention. Based on our data, the composite milk isolates are genetically similar to the housefly isolate. This provides evidence that the same Mycoplasma species found in milk and associated with mastitis can also be isolated from houseflies captured in the dairy environment.
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Affiliation(s)
- G. Gioia
- Quality Milk Production Services, Animal Health Diagnostic Center, Cornell University, Ithaca, New York, USA
| | - M. Severgnini
- Institute of Biomedical Technologies, National Research Council, Segrate, Milan, Italy
| | - P. Cremonesi
- Institute of Agricultural Biology and Biotechnology, National Research Council, Lodi, Italy
| | - B. Castiglioni
- Institute of Agricultural Biology and Biotechnology, National Research Council, Lodi, Italy
| | - J. Freeman
- Department of Entomology, College of Agriculture and Life Sciences, Cornell University, Ithaca, New York, USA
| | - A. Sipka
- Quality Milk Production Services, Animal Health Diagnostic Center, Cornell University, Ithaca, New York, USA
| | - C. Santisteban
- Quality Milk Production Services, Animal Health Diagnostic Center, Cornell University, Ithaca, New York, USA
| | - M. Wieland
- Quality Milk Production Services, Animal Health Diagnostic Center, Cornell University, Ithaca, New York, USA
| | - V. Alanis Gallardo
- Quality Milk Production Services, Animal Health Diagnostic Center, Cornell University, Ithaca, New York, USA
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City, Mexico
| | - J. G. Scott
- Department of Entomology, College of Agriculture and Life Sciences, Cornell University, Ithaca, New York, USA
| | - P. Moroni
- Quality Milk Production Services, Animal Health Diagnostic Center, Cornell University, Ithaca, New York, USA
- Dipartimento di Medicina Veterinaria e Scienze Animali, Università degli Studi di Milano, Lodi, Italy
- Laboratorio di Malattie Infettive degli Animali-MiLab, University of Milan, Lodi, Italy
| | - M. F. Addis
- Dipartimento di Medicina Veterinaria e Scienze Animali, Università degli Studi di Milano, Lodi, Italy
- Laboratorio di Malattie Infettive degli Animali-MiLab, University of Milan, Lodi, Italy
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7
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Guarini P, Saia F, Sidiropulos M, Silverio A, Dellegrottaglie S, Scatteia A, Tedeschi C, Cappelletti AM, Regazzoli D, Benassi A, Donatelli F, America R, Nosso G, Capranzano P, Oliva A, Piccolo R, Testa L, Attisano T, Castiglioni B, Contarini M, De Marco F, Fineschi M, Menozzi A, Musto C, Stefanini G, Tarantini G, Caiazza F, Esposito G. [SICI-GISE/SICOA Consensus document: Clinical follow-up of patients after acute coronary syndrome or percutaneous coronary intervention]. G Ital Cardiol (Rome) 2023; 24:5-15. [PMID: 37158025 DOI: 10.1714/4035.40099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
In the last decades, advances in percutaneous coronary intervention (PCI) strategies have significantly reduced the risk of procedural complications and in-hospital mortality of patients with acute coronary syndromes (ACS), thus increasing the population of stable post-ACS patients. This novel epidemiological scenario emphasizes the importance of implementing secondary preventive and follow-up strategies. The follow-up of patients after ACS or elective PCI should be based on common pathways and on the close collaboration between hospital cardiologists and primary care physicians. However, the follow-up strategies of these patients are still poorly standardized. This SICI-GISE/SICOA consensus document was conceived as a proposal for the long-term management of post-ACS or post-PCI patients based on their individual residual risk of cardiovascular adverse events. We defined five patient risk classes and five follow-up strategies including medical visits and examinations according to a specific time schedule. We also provided a short guidance for the selection of the appropriate imaging technique for the assessment of left ventricular ejection fraction and of non-invasive anatomical or functional tests for the detection of obstructive coronary artery disease. Physical and pharmacological stress echocardiography was identified as the first-line imaging technique in most of cases, while cardiovascular magnetic resonance should be preferred when an accurate evaluation of left ventricular ejection fraction is needed. The standardization of the follow-up pathways of patients with a history of ACS or elective PCI, shared between hospital doctors and primary care physicians, could result in a more cost-effective use of resources and potentially improve patient's long-term outcome.
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Affiliation(s)
| | - Francesco Saia
- U.O. Cardiologia, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola, Bologna
| | | | - Angelo Silverio
- Dipartimento di Medicina, Chirurgia ed Odontoiatria, Università degli Studi di Salerno, Baronissi (SA)
| | | | - Alessandra Scatteia
- Unità di Imaging Cardiovascolare Avanzato, Clinica Villa dei Fiori, Acerra (NA)
| | - Carlo Tedeschi
- U.O. Cardiologia, ASL Napoli 1 Centro, Presidio Intermedio Napoli Est, Napoli
| | | | | | | | | | | | | | | | - Angelo Oliva
- IRCCS Istituto Clinico Humanitas, Rozzano-Milano
| | - Raffaele Piccolo
- Dipartimento di Scienze Biomediche Avanzate, Università di Napoli "Federico II", Napoli
| | - Luca Testa
- Dipartimento di Cardiologia, IRCCS Policlinico San Donato, San Donato Milanese (MI)
| | - Tiziana Attisano
- Dipartimento Cardio-Toraco-Vascolare, AOU San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | | | | | - Federico De Marco
- U.O. Cardiologia Interventistica Valvolare e Strutturale, Centro Cardiologico Monzino, Milano
| | - Massimo Fineschi
- Cardiologia Interventistica, A.O. Universitaria Senese, Policlinico Le Scotte, Siena
| | - Alberto Menozzi
- S.C. Cardiologia, Ospedale Sant'Andrea, ASL5 Liguria, La Spezia
| | - Carmine Musto
- U.O.S. Cardiologia Interventistica, Azienda Ospedaliera San Camillo Forlanini, Roma
| | | | - Giuseppe Tarantini
- Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari, Policlinico Universitario, Padova
| | - Francesco Caiazza
- Dipartimento di Cardiologia, Pineta Grande Hospital, Castel Volturno (CE)
| | - Giovanni Esposito
- Dipartimento di Scienze Biomediche Avanzate, Università di Napoli "Federico II", Napoli
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8
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Compagnone M, Demola P, Serino F, Masiero G, Giuliani L, Rossi S, Polimeni A, Attisano T, Contarini M, Castiglioni B, De Marco F, Fineschi M, Menozzi A, Musto C, Saia F, Tarantini G, Esposito G. [Right heart catheterization in Italian catheterization laboratories: results of the SICI-GISE national survey promoted by the GISE Young Committee]. G Ital Cardiol (Rome) 2023; 24:30-38. [PMID: 37158031 DOI: 10.1714/4035.40105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Over the past decades, the improvements in the diagnostic power and availability of non-invasive cardiac imaging techniques have led to a decline of right heart catheterization (RHC) performance. However, RHC remains the gold standard for diagnosing pulmonary hypertension and an essential tool for the evaluation of patient candidacy to heart transplantation. METHODS This survey was carried out jointly by the Young Committee of GISE, with the support of the SICI-GISE Society, and the ICOT group, with the aim of evaluating how the interventional cardiology community perform RHC. A web-based questionnaire based on 20 questions was distributed to SICI-GISE members. RESULTS The survey was distributed to 1550 physicians with 174 (11%) responses. Most centers perform few procedures per year (<10 RHC/year) and a dedicated cardiologist is usually lacking. Patients were frequently admitted as ordinary hospitalization regimen and the most frequent indication for RHC was the hemodynamic assessment of pulmonary hypertension, followed by diagnostics of valvular diseases and advanced heart failure/heart transplantation. Indeed, the majority of participants (86%) are involved in transcatheter procedures for structural heart disease. The average time taken to perform the RHC was approximately 30-60 min. The femoral access (60%) was the most frequently used, usually by an echo-guided approach. Two-thirds of participants discontinued oral anticoagulant therapy before RHC. Only 27% of centers assess wedge position from an integrated analysis. Furthermore, the edge pressure is detected in the end-diastolic cardiac phase in half cases and in the end-expiratory phase in only 31%. The most commonly used method for cardiac output calculation was the indirect Fick method (58%). CONCLUSIONS Guidance on the best practice for performing RHC is currently lacking. A more precise standardization of this demanding procedure is warranted.
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Affiliation(s)
| | | | - Federica Serino
- Divisione di Cardiologia, A.O.R.N. Antonio Cardarelli, Napoli
| | - Giulia Masiero
- Dipartimnto di Scienze Cardio-Toraco-Vascolari e Sanità Pubblica, Università degli Studi, Padova
| | - Livio Giuliani
- U.O. Cardiologia Interventistica, Ospedale "SS. Annunziata", Chieti
| | - Serena Rossi
- U.O. Cardiologia Interventistica, Ospedale "SS. Annunziata", Chieti
| | - Alberto Polimeni
- Divisione di Cardiologia, Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi "Magna Graecia", Catanzaro
| | - Tiziana Attisano
- Divisione di Cardiologia Interventistica, Dipartimento Cardiotoracovascolare, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | - Marco Contarini
- Dipartimento di Cardiologia, Presidio Ospedaliero Umberto I, Siracusa
| | | | - Federico De Marco
- Dipartimento di Cardiologia Clinica e Interventistica, IRCCS Policlinico San Donato, San Donato Milanese (MI)
| | - Massimo Fineschi
- U.O.S.A. Cardiologia Interventistica, Azienda Ospedaliera Universitaria Senese, Siena
| | - Alberto Menozzi
- S.C. Cardiologia, Ospedale Sant'Andrea, ASL5 Liguria, La Spezia
| | - Carmine Musto
- Divisione di Cardiologia, Azienda Ospedaliera San Camillo, Roma
| | - Francesco Saia
- Alma Mater Studiorum, Università degli Studi di Bologna e IRCCS Policlinico Sant'Orsola, Bologna
| | - Giuseppe Tarantini
- Dipartimnto di Scienze Cardio-Toraco-Vascolari e Sanità Pubblica, Università degli Studi, Padova
| | - Giovanni Esposito
- Dipartimento di Scienze Biomediche Avanzate, Università di Napoli "Federico II", Napoli
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9
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Maisano AM, Luini M, Gazzola A, Sala L, Vezzoli F, Bertocchi L, Lorenzi V, Cremonesi P, Castiglioni B, Bergagna S, Romano A, Scaltriti E, Bolzoni L, Ivanovic I, Romanò A, Graber HU. Staphylococcus aureus adlb gene is associated with high prevalence of intramammary infection in dairy herds of northern Italy: A cross-sectional study. J Dairy Sci 2023; 106:3421-3435. [PMID: 36907760 DOI: 10.3168/jds.2022-22496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 11/16/2022] [Indexed: 03/12/2023]
Abstract
Staphylococcus aureus is a major mastitis pathogen in dairy cattle worldwide, responsible for substantial economic losses. Environmental factors, milking routine, and good maintenance of milking equipment have been described as important factors to prevent intramammary infections (IMI). Staphylococcus aureus IMI can be widespread within the farm or the infection can be limited to few animals. Several studies have reported that Staph. aureus genotypes differ in their ability to spread within a herd. In particular, Staph. aureus belonging to ribosomal spacer PCR genotype B (GTB)/clonal complex 8 (CC8) is associated with high within-herd prevalence of IMI, whereas other genotypes are generally associated with individual cow disease. The adlb gene seems to be strictly related to Staph. aureus GTB/CC8, and is a potential marker of contagiousness. We investigated Staph. aureus IMI prevalence in 60 herds in northern Italy. In the same farms, we assessed specific indicators linked to milking management (e.g., teat condition score and udder hygiene score) and additional milking risk factors for IMI spread. Ribosomal spacer-PCR and adlb-targeted PCR were performed on 262 Staph. aureus isolates, of which 77 underwent multilocus sequence typing. In most of the herds (90%), a predominant genotype was identified, especially Staph. aureus CC8 (30%). In 19 of 60 herds, the predominant circulating Staph. aureus was adlb-positive and the observed IMI prevalence was relevant. Moreover, the adlb gene was detected only in genotypes of CC8 and CC97. Statistical analysis showed a strong association between the prevalence of Staph. aureus IMI, the specific CCs, and carriage of adlb, with the predominant circulating CC and presence of the gene alone explaining the total variation. Interestingly, the difference in the odds ratio obtained in the models for CC8 and CC97 suggests that it is carriage of the adlb gene, rather than the circulation of these CCs per se, that leads to higher within-herd prevalence of Staph. aureus. In addition, the model showed that environmental and milking management factors had no or minimal effect on Staph. aureus IMI prevalence. In conclusion, the circulation of adlb-positive Staph. aureus strains within a herd has a strong effect on the prevalence of IMI. Thus, adlb can be proposed as a genetic marker of contagiousness for Staph. aureus IMI in cattle. However, further analyses using whole-genome sequencing are required to understand the role of genes other than adlb that may be involved in the mechanisms of contagiousness of Staph. aureus strains associated with high prevalence of IMI.
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Affiliation(s)
- A M Maisano
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna, 26900 Lodi, Italy.
| | - M Luini
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna, 26900 Lodi, Italy; Institute of Agricultural Biology and Biotechnology, National Research Council, 26900 Lodi, Italy
| | - A Gazzola
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna, 26900 Lodi, Italy
| | - L Sala
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna, 26900 Lodi, Italy
| | - F Vezzoli
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna, 26900 Lodi, Italy
| | - L Bertocchi
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna, Reparto Produzione e Controllo Materiale Biologico, 25124 Brescia, Italy
| | - V Lorenzi
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna, Reparto Produzione e Controllo Materiale Biologico, 25124 Brescia, Italy
| | - P Cremonesi
- Institute of Agricultural Biology and Biotechnology, National Research Council, 26900 Lodi, Italy
| | - B Castiglioni
- Institute of Agricultural Biology and Biotechnology, National Research Council, 26900 Lodi, Italy
| | - S Bergagna
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Laboratorio Benessere Animale, 10154 Torino, Italy
| | - A Romano
- Reference Laboratory for Coagulase-Positive Staphylococci Including Staphylococcus aureus, Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, 10154 Torino, Italy
| | - E Scaltriti
- Risk Analysis and Genomic Epidemiology Unit, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna, 43126 Parma, Italy
| | - L Bolzoni
- Risk Analysis and Genomic Epidemiology Unit, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna, 43126 Parma, Italy
| | - I Ivanovic
- Agroscope, Food Microbial Systems, Group Microbiological Safety of Foods of Animal Origin, 3003 Bern, Switzerland
| | - A Romanò
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna, 26900 Lodi, Italy; Agroscope, Food Microbial Systems, Group Microbiological Safety of Foods of Animal Origin, 3003 Bern, Switzerland
| | - H U Graber
- Agroscope, Food Microbial Systems, Group Microbiological Safety of Foods of Animal Origin, 3003 Bern, Switzerland
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10
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Toscano E, Demola P, Serino F, Masiero G, Polimeni A, Attisano T, Contarini M, Castiglioni B, De Marco F, Fineschi M, Menozzi A, Musto C, Saia F, Tarantini G, Esposito G. [Percutaneous transcatheter treatment of hypertension and heart failure: results of the SICI-GISE national survey promoted by the GISE Young Committee]. G Ital Cardiol (Rome) 2022; 23:27S-35S. [PMID: 36636873 DOI: 10.1714/3949.39290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND During the last decade, thanks to contemporary evidence and technological improvements, the role of interventional cardiology in the field of cardiac conditions that are mainly treated conservatively has grown a lot. In such scenario, drug-resistant arterial hypertension and heart failure (HF) have a significant role, considering the huge number of involved patients and their impact on mortality and quality of life. METHODS This survey was jointly performed by the GISE Young Committee with the support of the SICI-GISE Society and the ICOT group with the aim of evaluating the view of the cardiology community on interventional therapies for arterial hypertension and HF. A web-based questionnaire based on 22 questions was distributed online to SICI-GISE members. RESULTS The survey was distributed to 1550 physicians with 156 (10%) responses, 58% of whom was under 35 years of age. Renal denervation was available in 49% of Centers, its principal indication was the evidence of severe adverse reactions to anti-hypertensive drugs (80%). Most participants agreed that, compared to past years, there is more understanding of anatomical characteristics and improvement of devices, thus increasing procedural safety; however, main limitations were: appropriate patients' selection criteria (45%), lack of robust evidence (41%) and regulatory (36%) and economical (33%) factors. In the field of HF, this survey enlightened a wide availability of conventional therapies (i.e. mechanical circulatory support, defibrillators, resynchronization) in Italy; on the other side, there is limited availability of innovative devices (i.e. atrial decompression systems, transcatheter left ventricular reshaping). Many participants expressed enthusiastic attitude in this new field, with a look for the need of further evidence in terms of safety and efficacy. Finally, in the treatment of both acute and chronic HF, many participants expressed a problem of limited patient access to advanced therapies, mainly associated with suboptimal networking among institutions. CONCLUSIONS Device-based therapies for arterial hypertension and HF represent a promising option for selected patients; this survey highlights the importance of achieving good quality evidence in both fields, with the goal of proper identification of defined criteria for patients' selection and improvement of procedural and long-term safety and efficacy.
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Affiliation(s)
| | | | - Federica Serino
- Divisione di Cardiologia, A.O.R.N. Antonio Cardarelli, Napoli
| | - Giulia Masiero
- Dipartimento di Scienze Cardio-Toraco-Vascolari e Sanità Pubblica, Università degli Studi, Padova
| | - Alberto Polimeni
- Centro di Ricerche Cardiovascolari, Divisione di Cardiologia, Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi "Magna Graecia", Catanzaro
| | - Tiziana Attisano
- Divisione di Cardiologia Interventistica, Dipartimento Cardiotoracovascolare, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | - Marco Contarini
- U.O. Cardiologia con UTIC ed Emodinamica, Presidio Ospedaliero Umberto I, Siracusa
| | | | - Federico De Marco
- Dipartimento di Cardiologia Clinica e Interventistica, IRCCS Policlinico San Donato, San Donato Milanese (MI)
| | - Massimo Fineschi
- U.O.S.A. Cardiologia Interventistica, Azienda Ospedaliera Universitaria Senese, Siena
| | - Alberto Menozzi
- S.C. Cardiologia, Ospedale Sant'Andrea, ASL5 Liguria, La Spezia
| | - Carmine Musto
- Divisione di Cardiologia, Azienda Ospedaliera San Camillo, Roma
| | - Francesco Saia
- Alma Mater Studiorum, Università degli Studi di Bologna e IRCCS Policlinico Sant'Orsola, Bologna
| | - Giuseppe Tarantini
- Dipartimento di Scienze Cardio-Toraco-Vascolari e Sanità Pubblica, Università degli Studi, Padova
| | - Giovanni Esposito
- Dipartimento di Scienze Biomediche Avanzate, Università di Napoli "Federico II", Napoli
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11
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Morandi S, Cremonesi P, Arioli S, Stocco G, Silvetti T, Biscarini F, Castiglioni B, Greco D, D'Ascanio V, Mora D, Brasca M. Erratum to "Effect of using mycotoxin-detoxifying agents in dairy cattle feed on natural whey starter biodiversity" (J. Dairy Sci. 105:6513-6526). J Dairy Sci 2022; 105:8590. [PMID: 36116870 DOI: 10.3168/jds.2022-105-10-8590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 04/15/2022] [Indexed: 11/19/2022]
Affiliation(s)
- S Morandi
- Institute of Sciences of Food Production (ISPA), Italian National Research Council (CNR), Via Celoria 2, 20133, Milan, Italy
| | - P Cremonesi
- Institute of Agricultural Biology and Biotechnology (IBBA), Italian National Research Council (CNR), Via Einstein, 26900, Lodi, Italy
| | - S Arioli
- Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Via Celoria 2, 20133, Milan, Italy
| | - G Stocco
- Department of Veterinary Science, University of Parma, Via del Taglio 10, I-43126 Parma, Italy
| | - T Silvetti
- Institute of Sciences of Food Production (ISPA), Italian National Research Council (CNR), Via Celoria 2, 20133, Milan, Italy
| | - F Biscarini
- Institute of Agricultural Biology and Biotechnology (IBBA), Italian National Research Council (CNR), Via Einstein, 26900, Lodi, Italy
| | - B Castiglioni
- Institute of Agricultural Biology and Biotechnology (IBBA), Italian National Research Council (CNR), Via Einstein, 26900, Lodi, Italy
| | - D Greco
- Institute of Sciences of Food Production (ISPA), Italian National Research Council (CNR), Via Amendola 122/O, 70126, Bari, Italy
| | - V D'Ascanio
- Institute of Sciences of Food Production (ISPA), Italian National Research Council (CNR), Via Amendola 122/O, 70126, Bari, Italy
| | - D Mora
- Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Via Celoria 2, 20133, Milan, Italy
| | - M Brasca
- Institute of Sciences of Food Production (ISPA), Italian National Research Council (CNR), Via Celoria 2, 20133, Milan, Italy
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12
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Masiero G, Paradies V, Franzone A, Bellini B, De Biase C, Karam N, Sanguineti F, Mamas MA, Eltchaninoff H, Fraccaro C, Castiglioni B, Attisano T, Esposito G, Chieffo A. Sex-Specific Considerations in Degenerative Aortic Stenosis for Female-Tailored Transfemoral Aortic Valve Implantation Management. J Am Heart Assoc 2022; 11:e025944. [PMID: 36172929 DOI: 10.1161/jaha.121.025944] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The impact of sex on pathophysiological processes, clinical presentation, treatment options, as well as outcomes of degenerative aortic stenosis remain poorly understood. Female patients are well represented in transfemoral aortic valve implantation (TAVI) trials and appear to derive favorable outcomes with TAVI. However, higher incidences of major bleeding, vascular complications, and stroke have been reported in women following TAVI. The anatomical characteristics and pathophysiological features of aortic stenosis in women might guide a tailored planning of the percutaneous approach. We highlight whether a sex-based TAVI management strategy might impact on clinical outcomes. This review aimed to evaluate the impact of sex from diagnosis to treatment of degenerative aortic stenosis, discussing the latest evidence on epidemiology, pathophysiology, clinical presentation, therapeutic options, and outcomes. Furthermore, we focused on technical sex-oriented considerations in TAVI including the preprocedural screening, device selection, implantation strategy, and postprocedural management.
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Affiliation(s)
- Giulia Masiero
- Department of Cardiac, Thoracic Vascular Science and Public Health, University of Padova Italy
| | - Valeria Paradies
- Department of Cardiology Maasstad Hospital Rotterdam The Netherlands
| | - Anna Franzone
- Department of Advanced Biomedical Sciences Federico II University of Naples Italy
| | - Barbara Bellini
- Interventional Cardiology Unit IRCCS San Raffaele Scientific Institute Milan Italy
| | - Chiara De Biase
- Groupe CardioVasculaire Interventionnel Clinique Pasteur Toulouse France
| | - Nicole Karam
- Cardiology Department European Hospital Georges Pompidou Paris France
| | | | - Mamas A Mamas
- Keele Cardiovascular Research Group School of Medicine, Keele University Stoke-on-Trent United Kingdom.,Department of Cardiology Royal Stoke University Hospital Stoke-on-Trent United Kingdom.,Department of Medicine Thomas Jefferson University Philadelphia PA
| | | | - Chiara Fraccaro
- Department of Cardiac, Thoracic Vascular Science and Public Health, University of Padova Italy
| | | | - Tiziana Attisano
- Division of Interventional Cardiology Cardiovascular and Thoracic Department, San Giovanni di Dio e Ruggi Salerno Italy
| | - Giovanni Esposito
- Department of Advanced Biomedical Sciences Federico II University of Naples Italy
| | - Alaide Chieffo
- Interventional Cardiology Unit IRCCS San Raffaele Scientific Institute Milan Italy
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13
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Morandi S, Cremonesi P, Arioli S, Stocco G, Silvetti T, Biscarini F, Castiglioni B, Greco Ç, D'Ascanio V, Mora D, Brasca M. Effect of using mycotoxin-detoxifying agents in dairy cattle feed on natural whey starter biodiversity. J Dairy Sci 2022; 105:6513-6526. [PMID: 35840409 DOI: 10.3168/jds.2022-21793] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 04/15/2022] [Indexed: 11/19/2022]
Abstract
Natural whey cultures (NWC) are undefined multiple-strain bacterial starter communities that can be affected by even small changes along the entire dairy chain. We applied a multidisciplinary approach to investigate how the addition of 2 mycotoxin-detoxifying agents [sodium smectite and lignocellulose-based material (B1); leonardite and betaine (B2)] to cow diets modified the microbiota of the NWC in manufacture of a Grana-like cheese. Microbiological and flow cytometry analyses showed that the content and viability of lactic acid bacteria (LAB) and the total whey microbiota were not affected by the detoxifying agents, and Streptococcus thermophilus, Lactobacillus helveticus, and Limosilactobacillus fermentum were the dominant taxa. Random amplified polymorphic DNA-PCR fingerprinting and metagenomic analysis highlighted differences in the bacterial community of the NWC and in the relative abundance of Bacteroidetes that increased when B1 and B2 were included in the diet. Two of 6 St. thermophilus biotypes were detected only in control samples; conversely, none of the Lb. helveticus biotypes found in control samples were isolated from B1 and B2. In vitro tests showed that the 2 binders did not significantly affect the development of St. thermophilus, but they stimulated the growth of Lb. helveticus strains recovered only from B1 and B2 NWC. The addition of binders in cow feed can affect the LAB biotypes present in NWC.
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Affiliation(s)
- S Morandi
- Institute of Sciences of Food Production (ISPA), Italian National Research Council (CNR), Via Celoria 2, 20133, Milan, Italy.
| | - P Cremonesi
- Institute of Agricultural Biology and Biotechnology (IBBA), Italian National Research Council (CNR), Via Einstein, 26900, Lodi, Italy
| | - S Arioli
- Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Via Celoria 2, 20133, Milan, Italy
| | - G Stocco
- Department of Veterinary Science, University of Parma, Via del Taglio 10, I-43126 Parma, Italy
| | - T Silvetti
- Institute of Sciences of Food Production (ISPA), Italian National Research Council (CNR), Via Celoria 2, 20133, Milan, Italy
| | - F Biscarini
- Institute of Agricultural Biology and Biotechnology (IBBA), Italian National Research Council (CNR), Via Einstein, 26900, Lodi, Italy
| | - B Castiglioni
- Institute of Agricultural Biology and Biotechnology (IBBA), Italian National Research Council (CNR), Via Einstein, 26900, Lodi, Italy
| | - Ç Greco
- Institute of Sciences of Food Production (ISPA), Italian National Research Council (CNR), Via Amendola 122/O, 70126, Bari, Italy
| | - V D'Ascanio
- Institute of Sciences of Food Production (ISPA), Italian National Research Council (CNR), Via Amendola 122/O, 70126, Bari, Italy
| | - D Mora
- Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Via Celoria 2, 20133, Milan, Italy
| | - M Brasca
- Institute of Sciences of Food Production (ISPA), Italian National Research Council (CNR), Via Celoria 2, 20133, Milan, Italy
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14
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Beneduce A, Demola P, Masiero G, Serino F, Polimeni A, Saia F, Menozzi A, Contarini M, Fineschi M, Musto C, De Marco F, Castiglioni B, Attisano T, Tarantini G, Esposito G. [Percutaneous transcatheter treatment of pulmonary embolism: results of the SICI-GISE national survey promoted by the GISE-Young Committee]. G Ital Cardiol (Rome) 2022; 23:5S-12S. [PMID: 35848912 DOI: 10.1714/3838.38222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Pulmonary embolism (PE) represents the third leading acute cardiovascular syndrome in the world and it is burdened with high mortality and morbidity rates. Percutaneous or catheter-based treatments of high- and intermediate-risk patients have garnered interest because of the limitations of both systemic thrombolysis and anticoagulation strategies. However, data on these techniques are heterogeneous and limited to small non-randomized evidences. METHODS This survey was jointly performed by the GISE Young Committee with the support of the SICI-GISE Society and ICOT group with the aim of evaluating the view of the cardiology community on interventional therapies for PE. A web-based questionnaire based on 19 questions was distributed to SICI-GISE and ICOT members. RESULTS The survey was distributed to 1550 physicians with 220 (14%) responses, 65% from North Italy. Multidisciplinary diagnostic and therapeutic pathways for patients with PE were not available in most centers (56%), and transcatheter treatment was available in 55% of centers, most of them at low volume (<5 percutaneous treatments/year). Among the devices used, mechanical thrombectomy was the predominant one (62%) in the absence of significant differences in the availability of devices within the three Italian geographic macro-areas. Respondents recognize the theoretical benefits of percutaneous treatment of PE, including: improving a prompt hemodynamic stabilization and respiratory exchange (89%) in high-risk patients, avoiding hemodynamic deterioration (39%) and right ventricular dysfunction (51%) in intermediate-risk patients, and reducing hemorrhagic complications related to systemic thrombolysis (36%). According to participants' judgement, the main factors limiting the use of percutaneous transcatheter treatment of PE in clinical practice are the lack of specific operator training (60%), lack of solid clinical data to support it (39%), difficult patient selection (34%), high costs (30%), and risk of procedural complications (26%). CONCLUSIONS Currently, transcatheter treatment of PE appears to be widely supported but poorly used in clinical practice. Solid evidences are needed regarding the safety and efficacy profile of the different available devices, the identification of patient selection criteria, alongside the enhancement of the availability of techniques and technologies.
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Affiliation(s)
| | | | - Giulia Masiero
- Dipartimento di Scienze Cardio-Toraco-Vascolari e Sanità Pubblica, Università degli Studi, Padova
| | - Federica Serino
- Divisione di Cardiologia, A.O.R.N. Antonio Cardarelli, Napoli
| | - Alberto Polimeni
- Centro di Ricerche delle Malattie Cardiovascolari, Divisione di Cardiologia, Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi "Magna Graecia", Catanzaro
| | - Francesco Saia
- Alma Mater Studiorum, Università degli Studi di Bologna and IRCCS Policlinico Sant'Orsola, Bologna
| | - Alberto Menozzi
- S.C. Cardiologia, Ospedale Sant'Andrea, ASL5 Liguria, La Spezia
| | - Marco Contarini
- U.O. Cardiologia con UTIC ed Emodinamica, P.O. Umberto I, Siracusa
| | - Massimo Fineschi
- U.O.S.A. Cardiologia Interventistica, Azienda Ospedaliera Universitaria Senese, Siena
| | - Carmine Musto
- Divisione di Cardiologia, Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Federico De Marco
- Cardiologia Interventistica, IRCCS Policlinico San Donato, San Donato Milanese (MI)
| | | | - Tiziana Attisano
- Dipartimento di Cardiologia Interventistica, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | - Giuseppe Tarantini
- Dipartimento di Scienze Cardio-Toraco-Vascolari e Sanità Pubblica, Università degli Studi, Padova
| | - Giovanni Esposito
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi "Federico II", Napoli
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15
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Cassani G, Vecchi A, Perletti G, Roberto D, Castiglioni B. C88 EFFECT OF SARS–COV2 INFECTION ON ACUTE CORONARY SYNDROME: A RETROSPECTIVE OBSERVATIONAL STUDY. Eur Heart J Suppl 2022. [PMCID: PMC9384086 DOI: 10.1093/eurheartj/suac011.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Introduction In Northern Italy, from October 2020 to April 2021, the second wave of COVID–19 pandemic recorded the highest incidence of infections ever. In this semester, the Lombardy region alone counted 43,318 positive cases and 16,710 deaths. It is well known how COVID–19 leads to a negative prognosis in acute coronary syndrome (ACS). This study aims to analyze the dramatic consequences of SARS–CoV2 infection on patients with concomitant ACS during the worst pandemic period ever recorded in Northern Italy. Materials and Methods The study enrolled 255 consecutive patients who have been hospitalized for ACS (STEMI or NSTEMI) from October 2020 to April 2021, both from the hub and spoke hospitals. Two subgroups are compared: the first is composed of patients who have tested positive for at least one molecular SARS–CoV2 swab (at admission or during hospitalization), the other group is composed of patients who have been tested negative to SARS–CoV2 swab. Major clinical data, risk factors (RF), comorbidities, laboratory findings, reperfusion times, drug therapy, complications and in–hospital mortality were systematically collected. Results Patients main characteristics are shown in Table 1. No differences have been observed in clinical history, RF and comorbidities in the subgroups. At admission, the incidence of acute pulmonary edema (APE) and respiratory symptoms was significantly higher in the SARS–CoV2 group, respectively 14% (p = 0.005) and 18% (p = 0.017). No differences in the “onset to door” and “door to needle” delays have been recorded. The incidence of the composite in–hospital complications is markedly increased in SARS–CoV2 group. Compared to negative patients, a higher mortality rates (18% Vs. 4%; p = 0.017), higher incidences of acute renal failure (ARF) (18% Vs. 5%; p = 0.037), cardiogenic shock (14% Vs. 3%; p = 0.033) and a wider prescription of inotropes (23% Vs. 10%; p = 0.009) in the SARS–CoV2 cohort. Conclusion The study confirms the negative prognostic impact of COVID–19 infection on ACS, recording a significantly higher rate of all major complications, both related to ischemia with multiorgan failure and interstitial pneumonia. Higher incidence of APE, cardiogenic shock and ARF has been observed in SARS–CoV2 positive subgroup, which is corroborated by a quadrupled risk of in–hospital mortality in the COVID–19 cohort.
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Affiliation(s)
- G Cassani
- DIPARTIMENTO DI MEDICINA E CHIRURGIA, UNIVERSITÀ DEGLI STUDI DELL’INSUBRIA, VARESE; DIPARTIMENTO CARDIO–TORACO–VASCOLARE, ASST–SETTELAGHI, VARESE, TRADATE; DIPARTIMENTO DI BIOTECNOLOGIE E SCIENZE DELLA VITA, SEZIONE DI SCIENZE MEDICHE E CHIRURGICHE, UNIVERSITÀ DEGLI STUDI DELL’INSUBRIA, BUSTO ARSIZIO
| | - A Vecchi
- DIPARTIMENTO DI MEDICINA E CHIRURGIA, UNIVERSITÀ DEGLI STUDI DELL’INSUBRIA, VARESE; DIPARTIMENTO CARDIO–TORACO–VASCOLARE, ASST–SETTELAGHI, VARESE, TRADATE; DIPARTIMENTO DI BIOTECNOLOGIE E SCIENZE DELLA VITA, SEZIONE DI SCIENZE MEDICHE E CHIRURGICHE, UNIVERSITÀ DEGLI STUDI DELL’INSUBRIA, BUSTO ARSIZIO
| | - G Perletti
- DIPARTIMENTO DI MEDICINA E CHIRURGIA, UNIVERSITÀ DEGLI STUDI DELL’INSUBRIA, VARESE; DIPARTIMENTO CARDIO–TORACO–VASCOLARE, ASST–SETTELAGHI, VARESE, TRADATE; DIPARTIMENTO DI BIOTECNOLOGIE E SCIENZE DELLA VITA, SEZIONE DI SCIENZE MEDICHE E CHIRURGICHE, UNIVERSITÀ DEGLI STUDI DELL’INSUBRIA, BUSTO ARSIZIO
| | - D Roberto
- DIPARTIMENTO DI MEDICINA E CHIRURGIA, UNIVERSITÀ DEGLI STUDI DELL’INSUBRIA, VARESE; DIPARTIMENTO CARDIO–TORACO–VASCOLARE, ASST–SETTELAGHI, VARESE, TRADATE; DIPARTIMENTO DI BIOTECNOLOGIE E SCIENZE DELLA VITA, SEZIONE DI SCIENZE MEDICHE E CHIRURGICHE, UNIVERSITÀ DEGLI STUDI DELL’INSUBRIA, BUSTO ARSIZIO
| | - B Castiglioni
- DIPARTIMENTO DI MEDICINA E CHIRURGIA, UNIVERSITÀ DEGLI STUDI DELL’INSUBRIA, VARESE; DIPARTIMENTO CARDIO–TORACO–VASCOLARE, ASST–SETTELAGHI, VARESE, TRADATE; DIPARTIMENTO DI BIOTECNOLOGIE E SCIENZE DELLA VITA, SEZIONE DI SCIENZE MEDICHE E CHIRURGICHE, UNIVERSITÀ DEGLI STUDI DELL’INSUBRIA, BUSTO ARSIZIO
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16
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Refugjati T, Abenante A, Borsani N, Castiglioni B, Dentali F, De Ponti R. 486 A blue man standing. Eur Heart J Suppl 2021. [PMCID: PMC8689793 DOI: 10.1093/eurheartj/suab141.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
An 85-year-old was admitted in Internal Medic Ward for recurrent episodes of acute respiratory failure. His electrocardiogram showed a new onset of atrial flutter with spontaneous reversal to sinus rhythm (narrow QRS complex and normal atrioventricular conduction). The dyspnoea was worse with the patient sitting and was better when lying supine. Also, he report back pain associated to his major kyphoscoliosis. Results of chest radiography and blood test were normal. The arterial blood gas test revealed a hypocapnic hypoxemic respiratory failure, therefore the patient oxygen supplementation with noninvasive ventilation (NIV) was started, but peripheral oxygen saturation was persistently below 88% despite the high flow oxygenation. The patient underwent nasopharyngeal (NP) swab (ruling out SARS-CoV-2), high-resolution computed tomography (which was not pathologic), and computed tomography angiography (excluding pulmonary embolism). A transthoracic echocardiography was performed showing concentric hypertrophy, left atriomegaly and severe aortic ectasia of the root and of his ascending part, normal pulmonary pression and an aneurism of the interatrial septum with the presence of right-to-left shunt after using agitate saline contrast with Valsalva maneuver. Transesophageal echocardiography (TTE) confirmed the presence of severe structural interatrial septal abnormality with wide left convex aneurysm and an atrial septum defect (ASD) as ostium secundum, causing severe bidirectional shunt. Therefore, the patient underwent a successful transcatheter closure of secundum ASD with device Amplatzer Septal Occluder 018, while monitored with cardiac catheterization and transesophageal echocardiography. After few days, the patient was discharged at home without oxygen therapy. At the 3-month follow-up visit he reported no respiratory symptoms. Platypnea-orthodeoxia syndrome (POS) is an uncommon disorder characterized by dyspnoea and hypoxemia that occurs when the patient is sitting or standing and disappear quickly when recumbent. POS is characterized by both an anatomic and a functional component. The anatomic element is typically an interatrial communication such as ASD or Patent Foramen Ovale, which cause blood shunt left-to-right due to a higher pressure in left atrium and a greater compliance of the right ventricle, in the presence of normal pulmonary artery pressure. The syndrome occurs when a functional element, such as an increased atrial pressure or a decreased compliance of the right ventricle, reverses the flow. The shunts are often small and could remain asymptomatic: the high left atrial pressure let the defect close until there is a reverse pression which stretched atrial septum in particular in the upright position. In fact, when the patient is standing, the inferior vena cava comes in line with the defect increasing the right-to-left flow, sparking the respiratory symptoms. This could be linked to a cardiac or an extracardiac condition; in this case the presence of kyphoscoliosis and severe aortic ectasia of the root and of his ascending part, played an important role. The diagnosis is mainly made by echocardiography and cardiac catheterization to verify the mismatch in oxygen saturation between the pulmonary vein and the aorta. The diagnosis of POS is challenging, often considered only after other possible diagnosis is excluded. When POS is triggered by an interatrial defect in the absence of severe pulmonary hypertension, the usual treatment is a percutaneous or surgical closure.
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Affiliation(s)
- Taulant Refugjati
- Dipartimento Cardiovascolare, Ospedale di Circolo, Università Dell’Insubria, Varese, Italy
| | - Alessia Abenante
- Dipartimento di Medicina Interna, Ospedale di Cricolo, Univesità Dell’Insubria, Varese, Italy
| | - Nicoló Borsani
- Dipartimento di Medicina Interna, Ospedale di Cricolo, Univesità Dell’Insubria, Varese, Italy
| | - Battistina Castiglioni
- Dipartimento Cardiovascolare, Ospedale di Circolo, Università Dell’Insubria, Varese, Italy
| | - Francesco Dentali
- Dipartimento di Medicina Interna, Ospedale di Cricolo, Univesità Dell’Insubria, Varese, Italy
| | - Roberto De Ponti
- Dipartimento Cardiovascolare, Ospedale di Circolo, Università Dell’Insubria, Varese, Italy
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17
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Mallardi D, Tabasso C, Piemontese P, Morandi S, Silvetti T, Biscarini F, Cremonesi P, Castiglioni B, Pica V, Stuknyte M, De Noni I, Amato O, Liotto N, Mosca F, Roggero P. Inoculation of mother's own milk could personalize pasteurized donor human milk used for feeding preterm infants. J Transl Med 2021; 19:420. [PMID: 34627277 PMCID: PMC8502300 DOI: 10.1186/s12967-021-03096-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 09/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Human milk is a vehicle for bioactive compounds and beneficial bacteria which promote the establishment of a healthy gut microbiome of newborns, especially of preterm infants. Pasteurized donor human milk (PDHM) is the second-best option when preterm mother's own milk is unavailable. Since pasteurization affect the microbiological quality of donor milk, PDHM was inoculated with different preterm milk samples and then incubated, in order to evaluate the effect in terms of bacterial growth, human milk microbiome and proteolytic phenomena. METHODS In an in-vitro study PDHM was inoculated at 10% v/v using ten preterm milk samples. Microbiological, metataxonomic and peptidomic analyses, on preterm milk samples at the baseline (T0), on PDHM and on inoculated milk (IM) samples at T0, after 2 h (T1) and 4 h (T2) of incubation at 37 °C, were conducted. RESULTS IM samples at T2 showed a Total Bacterial Count not significantly different (p > 0.01) compared to preterm milk samples. At T2 lactic acid bacteria level was restored in all IM. After inoculation, metataxonomic analysis in IM samples showed that Proteobacteria remained the predominant phylum while Firmicutes moved from 3% at T1 to 9.4% at T2. Peptidomic profile of IM resembled that of PDHM, incubated for the same time, in terms of number and type of peptides. CONCLUSION The study demonstrated that inoculation of PDHM with mother's own milk could restore bacterial growth and personalize human milk microbiome in PDHM. This effect could be beneficial because of the presence of maternal probiotic bacteria which make PDHM more similar to mother's own milk.
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Affiliation(s)
- D Mallardi
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via della Commenda 12, 20122, Milan, Italy.
| | - C Tabasso
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via della Commenda 12, 20122, Milan, Italy
| | - P Piemontese
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via della Commenda 12, 20122, Milan, Italy
| | - S Morandi
- Institute of Sciences of Food Production (ISPA), National Research Council (CNR), Via Celoria 2, 20133, Milan, Italy
| | - T Silvetti
- Institute of Sciences of Food Production (ISPA), National Research Council (CNR), Via Celoria 2, 20133, Milan, Italy
| | - F Biscarini
- Institute of Agricultural Biology and Biotechnology (IBBA), National Research Council (CNR), U.O.S. Di Lodi, Via Einstein, 26900, Lodi, Italy
| | - P Cremonesi
- Institute of Agricultural Biology and Biotechnology (IBBA), National Research Council (CNR), U.O.S. Di Lodi, Via Einstein, 26900, Lodi, Italy
| | - B Castiglioni
- Institute of Agricultural Biology and Biotechnology (IBBA), National Research Council (CNR), U.O.S. Di Lodi, Via Einstein, 26900, Lodi, Italy
| | - V Pica
- Department of Food, Environmental and Nutritional Sciences, University of Milan, Via Celoria 2, 20133, Milan, Italy
| | - M Stuknyte
- Department of Food, Environmental and Nutritional Sciences, University of Milan, Via Celoria 2, 20133, Milan, Italy
| | - I De Noni
- Department of Food, Environmental and Nutritional Sciences, University of Milan, Via Celoria 2, 20133, Milan, Italy
| | - O Amato
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via della Commenda 12, 20122, Milan, Italy
| | - N Liotto
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via della Commenda 12, 20122, Milan, Italy
| | - F Mosca
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via della Commenda 12, 20122, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - P Roggero
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via della Commenda 12, 20122, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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18
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Isella C, Gasparini A, Lucca G, Ielmini M, Caselli I, Poloni N, Dajelli Ermolli C, Caravati F, Castiglioni B, De Ponti R, Callegari C. Resilience, Cardiological Outcome, and Their Correlations With Anxious-Depressive Symptoms and Quality of Life in Patients With an Implantable Cardioverter Defibrillator. Front Psychiatry 2021; 12:763726. [PMID: 34899424 PMCID: PMC8653768 DOI: 10.3389/fpsyt.2021.763726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/27/2021] [Indexed: 01/09/2023] Open
Abstract
Background: Resilience is proven as a protective factor against the development of psychiatric disorders, and it has gained clinical relevance in the development and progression of cardiovascular pathology. The authors performed a longitudinal study on patients with implantable cardioverter defibrillator (ICD) with the primary aim to highlight the possible existence of a correlation between individual resilience capacity, depressive and anxiety symptoms, and quality of life in terms of outcomes. The secondary aim was to analyze the differences between patients with major cardiac events in the follow-up and patients without cardiac events with respect to the previous variables. Materials and Methods: A total of 80 patients enrolled in the Cardiology Unit were evaluated at T0 and during the follow-up through the following scales: the 14-item Resilience Scale (RS-14), the Hospital Anxiety and Depression Scale (HADS), and the World Health Organization Quality of Life-Brief Version (WHOQOL-Bref). Results: A significant linear correlation between resilience and all the areas of quality of life at T0, T1, and T2 emerged. A negative correlation between resilience and anxiety and depressive symptoms emerged, as well as between depression and anxiety and quality of life. Patients with cardiac events during the follow up have shown a worse quality of life and the onset of anxiety-depressive symptoms over time, without changes to the resilience scores. Patients without cardiac events showed an increasing trend in resilience scores. Discussion: Given the speed and simplicity of use of the RS-14 scale, it seems promising to further investigate the real clinical usefulness of this instrument in the cardiology field.
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Affiliation(s)
- Celeste Isella
- Department of Medicine and Surgery, Section of Psychiatry, University of Insubria, Varese, Italy
| | - Alessandra Gasparini
- Department of Medicine and Surgery, Section of Psychiatry, University of Insubria, Varese, Italy
| | - Giulia Lucca
- Department of Medicine and Surgery, Section of Psychiatry, University of Insubria, Varese, Italy
| | - Marta Ielmini
- Department of Medicine and Surgery, Section of Psychiatry, University of Insubria, Varese, Italy
| | - Ivano Caselli
- Department of Medicine and Surgery, Section of Psychiatry, University of Insubria, Varese, Italy
| | - Nicola Poloni
- Department of Medicine and Surgery, Section of Psychiatry, University of Insubria, Varese, Italy
| | - Carlo Dajelli Ermolli
- Department of Heart and Vessels, Ospedale di Circolo, University of Insubria, Varese, Italy
| | - Fabrizio Caravati
- Department of Heart and Vessels, Ospedale di Circolo, University of Insubria, Varese, Italy
| | - Battistina Castiglioni
- Department of Heart and Vessels, Ospedale di Circolo, University of Insubria, Varese, Italy
| | - Roberto De Ponti
- Department of Heart and Vessels, Ospedale di Circolo, University of Insubria, Varese, Italy
| | - Camilla Callegari
- Department of Medicine and Surgery, Section of Psychiatry, University of Insubria, Varese, Italy
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19
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Cabrini L, Ageno W, Balbi S, Baruzzi F, Candeloro E, Capra C, Carimati F, Castiglioni B, Conti V, DE Ponti R, Franchi D, Gini G, Giorgianni A, Sartorelli M, Landoni G, Locatelli D, Maffioli L, Pradella R, Severgnini P, Tozzi M, Versino M, Zocchi G, Zoli A. Caring for acute coronary syndrome and other time-sensitive medical emergencies during the coronavirus disease 2019 pandemic in Northern Italy: report from a hub center. Minerva Cardiol Angiol 2020; 70:303-309. [PMID: 33258565 DOI: 10.23736/s2724-5683.20.05384-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The Lombardy region, in Northern Italy, suffered a major outbreak of Coronavirus disease 2019 (COVID-19) at the end of February 2020. The health system was rapidly overwhelmed by the pandemic. It became evident that patients suffering from time-sensitive medical emergencies like stroke, cerebral hemorrhage, trauma and acute myocardial infarction required timely, effective and safe pathways to be treated. The problem was addressed by a regional decree that created a hub-and-spoke system for time-sensitive medical emergencies. METHODS We report the re-organizational changes adopted at a hub hospital (despite having already destined to COVID-19 patients most resources), and the number of emergent procedures for medical emergencies on the first 30-day of activity. These data were compared with the hospital activity in the same period of the previous year. RESULTS Organizational changes were implemented in few hours. Dedicated pathways for non-COVID-19 patients affected by a medical emergency were set up in the emergency department, in the labs and in the operating theater. Ten intensive beds were implemented from a high-dependency unit; two operating rooms were reserved 24 h/day to neurosurgical or trauma emergencies. The number of emergent procedures was not different from that of the previous year, no admission refusal, no treatment delay and no viral transmission to the treated patients were recorded. No viral transmission to health care workers was observed. CONCLUSIONS Re-organization of a hospital in order to adopt a hub-and-spoke model resulted feasible and allowed to face acute coronary syndrome and other time-sensitive medical emergencies timely and safely.
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Affiliation(s)
- Luca Cabrini
- University of Insubria, Varese, Italy.,Ospedale di Circolo e Fondazione Macchi, ASST Settelaghi, Varese, Italy
| | - Walter Ageno
- University of Insubria, Varese, Italy.,Emergency Department, Ospedale di Circolo e Fondazione Macchi, ASST Settelaghi, Varese, Italy
| | - Sergio Balbi
- University of Insubria, Varese, Italy.,Department of Neurological Surgery, Ospedale di Circolo e Fondazione Macchi, ASST Settelaghi, Varese, Italy
| | - Fabio Baruzzi
- Department of Neuroradiology, Ospedale di Circolo e Fondazione Macchi, ASST Settelaghi, Varese, Italy
| | - Elisa Candeloro
- Department of Neurology and Stroke Unit, Ospedale di Circolo e Fondazione Macchi, ASST Settelaghi, Varese, Italy
| | - Carlo Capra
- Ospedale di Circolo e Fondazione Macchi, ASST Settelaghi, Varese, Italy
| | - Federico Carimati
- Department of Neurology and Stroke Unit, Ospedale di Circolo e Fondazione Macchi, ASST Settelaghi, Varese, Italy
| | - Battistina Castiglioni
- Department of Cardiology, Luigi Galmarini Hospital, ASST Settelaghi, Tradate, Varese, Italy
| | - Vinicio Conti
- University of Insubria, Varese, Italy.,Ospedale di Circolo e Fondazione Macchi, ASST Settelaghi, Varese, Italy
| | - Roberto DE Ponti
- University of Insubria, Varese, Italy.,Ospedale di Circolo e Fondazione Macchi, ASST Settelaghi, Varese, Italy
| | | | - Giancarlo Gini
- Emergency Department, Ospedale di Circolo e Fondazione Macchi, ASST Settelaghi, Varese, Italy
| | - Andrea Giorgianni
- Department of Neuroradiology, Ospedale di Circolo e Fondazione Macchi, ASST Settelaghi, Varese, Italy
| | - Marianna Sartorelli
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giovanni Landoni
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy - .,Faculty of Medicine, Vita Salute San Raffaele University, Milan, Italy
| | - Davide Locatelli
- University of Insubria, Varese, Italy.,Department of Neurological Surgery, Ospedale di Circolo e Fondazione Macchi, ASST Settelaghi, Varese, Italy
| | | | - Rita Pradella
- University of Insubria, Varese, Italy.,Ospedale di Circolo e Fondazione Macchi, ASST Settelaghi, Varese, Italy
| | - Paolo Severgnini
- University of Insubria, Varese, Italy.,Department of Biotechnology and Sciences of Life, Ospedale di Circolo e Fondazione Macchi, ASST Settelaghi, Varese, Italy
| | - Matteo Tozzi
- University of Insubria, Varese, Italy.,Ospedale di Circolo e Fondazione Macchi, ASST Settelaghi, Varese, Italy
| | - Maurizio Versino
- University of Insubria, Varese, Italy.,Department of Neurology and Stroke Unit, Ospedale di Circolo e Fondazione Macchi, ASST Settelaghi, Varese, Italy
| | - Giuliano Zocchi
- University of Insubria, Varese, Italy.,Ospedale di Circolo e Fondazione Macchi, ASST Settelaghi, Varese, Italy
| | - Alberto Zoli
- Lombardy EMS Regional Agency (AREU), Milan, Italy
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20
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Cabrini L, Ageno W, Balbi S, Baruzzi F, Candeloro E, Capra C, Carimati F, Castiglioni B, Conti V, De Ponti R, Franchi D, Gini G, Giorgianni A, Sartorelli M, Landoni G, Locatelli D, Maffioli L, Pradella R, Severgnini P, Tozzi M, Versino M, Zocchi G, Zoli A. Caring for acute coronary syndrome and other time-sensitive medical emergencies during the coronavirus disease 2019 pandemic in Northern Italy: report from a hub centre. Minerva Cardioangiol 2020. [PMID: 33258565 DOI: 10.23736/s0026-4725.20.05384-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The Lombardy region, in Northern Italy, suffered a major outbreak of Coronavirus disease 2019 (COVID-19) at the end of February 2020. The health system was rapidly overwhelmed by the pandemic. It became evident that patients suffering from timesensitive medical emergencies like stroke, cerebral hemorrhage, trauma and acute myocardial infarction required timely, effective and safe pathways to be treated. The problem was addressed by a regional decree that created a hub-and-spoke system for time-sensitive medical emergencies. METHODS We report the re-organizational changes adopted at a hub hospital (despite having already destined to COVID-19 patients most resources), and the number of emergent procedures for medical emergencies on the first 30-day of activity. These data were compared with the hospital activity in the same period of the previous year. RESULTS Organizational changes were implemented in few hours. Dedicated pathways for non-COVID-19 patients affected by a medical emergency were set up in the emergency department, in the labs and in the operating theater. Ten intensive beds were implemented from a high-dependency unit; two operating rooms were reserved 24h/day to neurosurgical or trauma emergencies. The number of emergent procedures was not different from that of the previous year, no admission refusal, no treatment delay and no viral transmission to the treated patients were recorded. No viral transmission to health care workers was observed. CONCLUSIONS Re-organization of a hospital in order to adopt a hub-and-spoke model resulted feasible and allowed to face acute coronary syndrome and other time-sensitive medical emergencies timely and safely.
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Affiliation(s)
- Luca Cabrini
- Università degli Studi dell'Insubria, Varese, Italy.,Ospedale di Circolo e Fondazione Macchi, Varese, ASST-Settelaghi, Varese, Italy
| | - Walter Ageno
- Università degli Studi dell'Insubria, Varese, Italy.,Emergency Department, Ospedale di Circolo e Fondazione Macchi, Varese, ASST-Settelaghi, Varese, Italy
| | - Sergio Balbi
- Department of of Biotechnology and Sciences of Life, Ospedale di Circolo e Fondazione Macchi, Varese, ASST-Settelaghi, Varese, Italy.,Department of Neurological Surgery, Ospedale di Circolo e Fondazione Macchi, Varese, ASST-Settelaghi, Varese, Italy
| | - Fabio Baruzzi
- Department of Neuroradiology, Ospedale di Circolo e Fondazione Macchi, Varese, ASST-Settelaghi, Varese, Italy
| | - Elisa Candeloro
- Department of Neurology and Stroke Unit, Ospedale di Circolo e Fondazione Macchi, Varese, ASST-Settelaghi, Varese, Italy
| | - Carlo Capra
- Ospedale di Circolo e Fondazione Macchi, Varese, ASST-Settelaghi, Varese, Italy
| | - Federico Carimati
- Department of Neurology and Stroke Unit, Ospedale di Circolo e Fondazione Macchi, Varese, ASST-Settelaghi, Varese, Italy
| | - Battistina Castiglioni
- Department of Cardiology, Ospedale Luigi Galmarini, Tradate, ASST-Settelaghi, Varese, Italy
| | - Vinicio Conti
- Università degli Studi dell'Insubria, Varese, Italy.,Ospedale di Circolo e Fondazione Macchi, Varese, ASST-Settelaghi, Varese, Italy
| | - Roberto De Ponti
- Università degli Studi dell'Insubria, Varese, Italy.,Ospedale di Circolo e Fondazione Macchi, Varese, ASST-Settelaghi, Varese, Italy
| | | | - Giancarlo Gini
- Emergency Department, Ospedale di Circolo e Fondazione Macchi, Varese, ASST-Settelaghi, Varese, Italy
| | - Andrea Giorgianni
- Department of Neuroradiology, Ospedale di Circolo e Fondazione Macchi, Varese, ASST-Settelaghi, Varese, Italy
| | - Marianna Sartorelli
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giovanni Landoni
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy - .,Faculty of Medicine, Vita Salute San Raffaele University, Milan, Italy
| | - Davide Locatelli
- Università degli Studi dell'Insubria, Varese, Italy.,Department of Neurological Surgery, Ospedale di Circolo e Fondazione Macchi, Varese, ASST-Settelaghi, Varese, Italy
| | | | - Rita Pradella
- Università degli Studi dell'Insubria, Varese, Italy.,Ospedale di Circolo e Fondazione Macchi, Varese, ASST-Settelaghi, Varese, Italy
| | - Paolo Severgnini
- Università degli Studi dell'Insubria, Varese, Italy.,Department of of Biotechnology and Sciences of Life, Ospedale di Circolo e Fondazione Macchi, Varese, ASST-Settelaghi, Varese, Italy
| | - Matteo Tozzi
- Università degli Studi dell'Insubria, Varese, Italy.,Ospedale di Circolo e Fondazione Macchi, Varese, ASST-Settelaghi, Varese, Italy
| | - Maurizio Versino
- Università degli Studi dell'Insubria, Varese, Italy.,Department of Neurology and Stroke Unit, Ospedale di Circolo e Fondazione Macchi, Varese, ASST-Settelaghi, Varese, Italy
| | - Giuliano Zocchi
- Università degli Studi dell'Insubria, Varese, Italy.,Ospedale di Circolo e Fondazione Macchi, Varese, ASST-Settelaghi, Varese, Italy
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21
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Tarantini G, Mojoli M, Varbella F, Caporale R, Rigattieri S, Andò G, Cirillo P, Pierini S, Santarelli A, Sganzerla P, De Cesare N, Limbruno U, Lupi A, Ricci R, Cernetti C, Favero L, Saia F, Roncon L, Gasparetto V, Ferlini M, Ronco F, Ferri L, Trabattoni D, Russo A, Guiducci V, Penzo C, Tarantino F, Mauro C, Marchese A, Castiglioni B, La Manna A, Martinato M, Gregori D, Angiolillo DJ, Musumeci G. Downstream or upstream administration of P2Y12 receptor blockers in non-ST elevated acute coronary syndromes: study protocol for a randomized controlled trial. Trials 2020; 21:966. [PMID: 33234137 PMCID: PMC7686679 DOI: 10.1186/s13063-020-04859-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 11/01/2020] [Indexed: 11/10/2022] Open
Abstract
Background The optimal timing to administer a P2Y12 inhibitor in patients presenting with a non-ST elevation acute coronary syndrome remains a topic of debate. Pretreatment with ticagrelor before coronary anatomy is known as a widely adopted strategy. However, there is poor evidence on how this compares with administration of a P2Y12 inhibitor after defining coronary anatomy (i.e., downstream administration). Moreover, there are limited head-to-head comparisons of the two P2Y12 inhibitors—ticagrelor and prasugrel—currently recommended by the guidelines. Study design DUBIUS is a phase 4, multicenter, parallel-group, double randomized study conducted in NSTE-ACS patients designed to compare a pretreatment strategy (including only ticagrelor) versus a downstream strategy (including prasugrel or ticagrelor) and to compare downstream prasugrel with downstream ticagrelor. A total of 2520 patients will be randomly assigned to pretreatment with ticagrelor or to no pretreatment. The PCI group of the downstream arm will be further randomized to receive prasugrel or ticagrelor. The two primary hypotheses are that the downstream strategy is superior to the upstream strategy and that downstream ticagrelor is non-inferior to downstream prasugrel, both measured by the incidence of a composite efficacy and safety endpoint of death from vascular causes, non-fatal MI, or non-fatal stroke, and Bleeding Academic Research Consortium (BARC) type 3, 4, and 5 bleedings. Conclusions The DUBIUS study will provide important evidence related to the benefits and risks of pretreatment with ticagrelor compared with a strategy of no pretreatment. Moreover, the clinical impact of using downstream ticagrelor compared with downstream prasugrel will be assessed. Trial registration ClinicalTrials.gov NCT02618837. Registered on 1 December 2015. Supplementary information Supplementary information accompanies this paper at 10.1186/s13063-020-04859-1.
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Affiliation(s)
- Giuseppe Tarantini
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, Policlinico Universitario, University of Padova, Via Giustiniani 2, 35128, Padova, Italy.
| | - Marco Mojoli
- Ospedale Santa Maria degli Angeli, Pordenone, Italy
| | | | | | | | - Giuseppe Andò
- Azienda Ospedaliera Universitaria Policlinico "Gaetano Martino", Messina, Italy
| | | | | | | | | | | | | | - Alessandro Lupi
- Ospedale Universitario "Maggiore della Carità", Novara, Italy
| | | | | | | | - Francesco Saia
- University Hospital of Bologna Sant'Orsola-Malpighi, Bologna, Italy
| | - Loris Roncon
- Hospital Santa Maria della Misericordia, Rovigo, Italy
| | | | | | | | | | | | | | | | - Carlo Penzo
- Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Ferrara, Italy
| | | | - Ciro Mauro
- Antonio Cardarelli Hospital, Naples, Italy
| | | | | | | | - Matteo Martinato
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, Policlinico Universitario, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Dario Gregori
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, Policlinico Universitario, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Dominick J Angiolillo
- Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, USA
| | - Giuseppe Musumeci
- Division of Cardiology, Azienda Sanitaria Ospedaliera Ordine Mauriziano, Torino, Italy
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22
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Carugo S, Ferlini M, Castini D, Andreassi A, Guagliumi G, Metra M, Lombardi C, Cuccia C, Savonitto S, Piatti L, D'Urbano M, Lettieri C, Vandoni P, Lettino M, Marenzi G, Montorfano M, Zangrillo A, Castiglioni B, De Ponti R, Oltrona Visconti L. Management of acute coronary syndromes during the COVID-19 outbreak in Lombardy: The "macro-hub" experience. Int J Cardiol Heart Vasc 2020; 31:100662. [PMID: 33173807 PMCID: PMC7609053 DOI: 10.1016/j.ijcha.2020.100662] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/06/2020] [Accepted: 10/08/2020] [Indexed: 01/22/2023]
Abstract
Background During the COVID-19 outbreak, healthcare Authorities of Lombardy modified the regional network concerning time-dependent emergencies. Specifically, 13 Macro-Hubs were identified to deliver timely optimal care to patients with acute coronary syndromes (ACS). Aim of this paper is to present the results of this experience. Methods and Results This is a multicenter, observational study. A total of 953 patients were included, presenting with STEMI in 57.7% of the cases. About 98% of patients received coronary angiography with a median since first medical contact to angiography of 79 (IQR 45–124) minutes for STEMI and 1262 (IQR 643–2481) minutes for NSTEMI. A total of 107 patients (11.2%) had SARS-CoV2 infection, mostly with STEMI (74.8%). The time interval from first medical contact to cath-lab was significant shorter in patients with COVID-19, both in the overall population and in STEMI patients (87 (IQR 41–310) versus 160 (IQR 67–1220) minutes, P = 0.001, and 61 (IQR 23–98) versus 80 (IQR 47–126) minutes, P = 0.01, respectively). In-hospital mortality and cardiogenic shock rates were higher among patients with COVID-19 compared to patients without (32% vs 6%, P < 0.0001, and 16.8% vs 6.7%, P < 0.0003, respectively). Conclusions During the COVID-19 outbreak in Lombardy, the redefinition of ACS network according to enlarged Macro-Hubs allowed to continue with timely ACS management, while reserving a high number of intensive care beds for the pandemic. Patients with ACS and COVID-19 presented a worst outcome, particularly in case of STEMI.
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Affiliation(s)
- Stefano Carugo
- Cardiology Department, University of Milan, ASST Santi Paolo e Carlo, Milano, Italy
| | - Marco Ferlini
- Cardiology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Diego Castini
- Cardiology Department, University of Milan, ASST Santi Paolo e Carlo, Milano, Italy
| | | | - Giulio Guagliumi
- Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Marco Metra
- Cardiology Department, University of Brescia, ASST Spedali Civili, Brescia, Italy
| | - Carlo Lombardi
- Cardiology Department, University of Brescia, ASST Spedali Civili, Brescia, Italy
| | - Claudio Cuccia
- Cardiology Department, Poliambulanza Hospital, Brescia, Italy
| | | | - Luigi Piatti
- Cardiology Department, Manzoni Hospital, ASST Lecco, Italy
| | | | | | - Pietro Vandoni
- Cardiology Department, San Gerardo Hospital, ASST Monza, Italy
| | | | - Giancarlo Marenzi
- IRCCS Centro Cardiologico Monzino, University of Milan, Milano, Italy
| | | | | | | | - Roberto De Ponti
- Cardiology Department, Tradate Hospital, ASST Settelaghi Varese, Italy
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23
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Ferlini M, Rossini R, Musumeci G, Cornara S, Somaschini A, Grieco N, Marino M, Calchera I, Cardile A, Colombo P, Martinoni A, Ielasi A, Castiglioni B, Lettieri C, Tarantini G, Oltrona Visconti L. Dual antiplatelet therapy prolongation in high-risk patients with prior myocardial infarction: insights from the post-PCI registry. J Cardiovasc Med (Hagerstown) 2020; 21:603-609. [PMID: 32520857 DOI: 10.2459/jcm.0000000000000988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Patients surviving a myocardial infarction (MI) are at a heightened risk for recurrent ischemic events that can be reduced with the long-term addition of a second antithrombotic drug to aspirin. However, data about real prescription of this therapy are lacking and sometimes controversial. METHODS We aimed to describe the incidence and the determinants of a dual antiplatelet therapy (DAPT) prolongation beyond 12 months in a cohort of consecutive patients undergoing percutaneous coronary intervention (PCI) with prior MI undergoing PCI and features of high ischemic risk intended as age more than 65 years, second MI, type 2 diabetes mellitus, multivessel coronary artery disease (MVCAD) and chronic kidney disease (CKD). We analysed patients enrolled in the prospective 'Post-PCI' registry that included patients treated with PCI for stable coronary artery disease (CAD) or acute coronary syndromes. At 12 months' follow-up, we collected data about DAPT prolongation in patients with prior MI and at least one of the previous features of high risk who did not experience ischemic and bleeding events during the follow-up. RESULTS Among 1113 patients included in the registry, 778 (72%) presented the inclusion criteria for the present study: 434 (66%) were more than 65 years old, 245 (37%) had a second MI, 189 (29%) diabetes mellitus, 480 (73%) MVCAD and 216 (33%) CKD. Despite a DAPT being prescribed for 1 year in 86% of the patients, it was prolonged for over 12 months in 105 (16%) of them. At multivariable analysis, only second MI and MVCAD were independent predictors of DAPT prolongation in a model including age more than 65 years, diabetes mellitus, CKD and PCI on left main/left anterior descending coronary artery. We found no significant difference in DAPT prolongation according to a DAPT-score value at least 2 or based on the physician who actually performed the follow-up (clinical cardiologist, interventional cardiologist or other). CONCLUSION In patients with prior MI and features of high ischemic risk undergoing PCI, the rate of DAPT prolongation beyond 12 months was low; recurrent MI and MVCAD appeared as its main determinants.
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Affiliation(s)
- Marco Ferlini
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia
| | - Roberta Rossini
- Dipartimento Emergenze e Aree Critiche, Ospedale Santa Croce e Carle, Cuneo
| | - Giuseppe Musumeci
- Dipartimento Emergenze e Aree Critiche, Ospedale Santa Croce e Carle, Cuneo
| | - Stefano Cornara
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia.,Department of Molecular Medicine, Unit of Cardiology, University of Pavia, Pavia
| | - Alberto Somaschini
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia.,Department of Molecular Medicine, Unit of Cardiology, University of Pavia, Pavia
| | - Niccolò Grieco
- Cardiology Department, Niguarda Ca'Granda Hospital, Milan
| | | | | | | | - Paola Colombo
- Department of Clinical Governance, Niguarda Ca'Granda Hospital, Milano
| | | | | | | | - Corrado Lettieri
- Department of Cardiology, ASST Mantova-Ospedale Carlo Poma, Mantova
| | - Giuseppe Tarantini
- Interventional Cardiology UOSD, Department of Cardiac, Thoracic and Vascular Science, Padova University Hospital, Padova, Italy
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24
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Ferlini M, Musumeci G, Grieco N, Trabattoni D, Castiglioni B, Lettieri C, Klersy C, Tarantini G, Oltrona Visconti L, Rossini R. Follow‐up strategies and individual risk profile after percutaneous coronary intervention: The prospective post percutaneous coronary intervention registry. Catheter Cardiovasc Interv 2020; 97:E209-E218. [DOI: 10.1002/ccd.28964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/03/2020] [Accepted: 04/25/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Marco Ferlini
- Division of Cardiology Fondazione IRCCS Policlinico San Matteo Pavia Italy
| | - Giuseppe Musumeci
- Dipartimento Emergenze e Aree Critiche Ospedale Santa Croce e Carle Cuneo Italy
| | | | - Daniela Trabattoni
- Department of Cardiovascular Sciences Centro Cardiologico Monzino, IRCCS Milan Italy
| | | | - Corrado Lettieri
- Division of Cardiology ASST Mantova‐Ospedale Carlo Poma Mantova Italy
| | - Catherine Klersy
- Clinical Epidemiology & Biometry Unit Fondazione IRCCS Policlinico Pavia Italy
| | - Giuseppe Tarantini
- Department of Cardiac, Thoracic and Vascular Science Padova University Hospital Padova Italy
| | | | - Roberta Rossini
- Dipartimento Emergenze e Aree Critiche Ospedale Santa Croce e Carle Cuneo Italy
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25
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Ferlini M, Andreassi A, Carugo S, Cuccia C, Bianchini B, Castiglioni B, D' Urbano M, Guagliumi G, Lettieri C, Lettino M, Marenzi G, Metra M, Migliori M, Montorfano M, Oliva F, Savonitto S, Seregni R, Visconti LO. Centralization of the ST elevation myocardial infarction care network in the Lombardy region during the COVID-19 outbreak. Int J Cardiol 2020; 312:24-26. [PMID: 32339543 PMCID: PMC7195067 DOI: 10.1016/j.ijcard.2020.04.062] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 04/22/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Marco Ferlini
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Stefano Carugo
- Division of Cardiology Ospedale San Paolo, Polo Universitario, ASST Santi Paolo e Carlo, Milan, Italy
| | - Claudio Cuccia
- Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Beatrice Bianchini
- Division of Cardiology, Ospedale Civile di Sondrio, ASST Valtellina e Alto Lario, Italy
| | - Battistina Castiglioni
- Cardiovascular Department, Division of Cardiology - Tradate, ASST Sette Laghi, Varese, Italy
| | | | - Giulio Guagliumi
- Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Maddalena Lettino
- Division of Cardiology, Ospedale San Gerardo di Monza, ASST Monza, Italy
| | | | - Marco Metra
- Cardiology Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia, Brescia, Italy
| | | | - Matteo Montorfano
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Fabrizio Oliva
- Division of Cardiology 1 De Gasperis Cardiocenter, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | - Romano Seregni
- Division of Cardiology, FBF ASST Fatebenefratelli-Sacco, Milan, Italy
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26
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Tarantini G, Fraccaro C, Chieffo A, Marchese A, Tarantino FF, Rigattieri S, Limbruno U, Mauro C, La Manna A, Castiglioni B, Longoni M, Berti S, Greco F, Musumeci G, Esposito G. Italian Society of Interventional Cardiology (GISE) position paper for Cath lab-specific preparedness recommendations for healthcare providers in case of suspected, probable or confirmed cases of COVID-19. Catheter Cardiovasc Interv 2020; 96:839-843. [PMID: 32223063 PMCID: PMC7228289 DOI: 10.1002/ccd.28888] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 03/25/2020] [Indexed: 01/19/2023]
Abstract
COVID‐19 pandemic raised the issue to guarantee the proper level of care to patients with acute cardiovascular diseases and concomitant suspected or confirmed COVID‐19 and, in the meantime safety and protection of healthcare providers. The aim of this position paper is to provide standards to healthcare facilities and healthcare providers on infection prevention and control measures during the management of suspected and confirmed cases of 2019‐nCoV infection accessing in cath‐lab. The document represents the view of the Italian Society of Interventional Cardiology (GISE), and it is based on recommendations from the main World and European Health Organizations (WHO, and ECDC) as well as from the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI).
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Affiliation(s)
- Giuseppe Tarantini
- Department of Cardiac, Thoracic, Vascular Sciences, University of Padua, Padua, Italy
| | - Chiara Fraccaro
- Department of Cardiac, Thoracic, Vascular Sciences, University of Padua, Padua, Italy
| | - Alaide Chieffo
- Interventional Cardiology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | | | | | | | - Ugo Limbruno
- Dipartimento Cardio-neuro-vascolare, Azienda USL Toscana Sud-est, Ospedale di Grosseto, Grosseto, Italy
| | - Ciro Mauro
- A.O.R.N. A. Cardarelli, UOC Cardiologia, Naples, Italy
| | - Alessio La Manna
- Division of Cardiology, Dipartimento Cardio-Toraco-Vascolare e Trapianto d'organi - CAST, Policlinico Hospital, Catania, Italy
| | | | - Matteo Longoni
- Interventional Cardiology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | - Sergio Berti
- U.O.C. Cardiologia Diagnostica e Interventistica, Dipartimento Cardiotoracico, Fondazione Toscana G. Monasterio - Ospedale del Cuore G. Pasquinucci, Massa, Italy
| | - Francesco Greco
- Division of Cardiology, Ospedale Civile SS Annunziata, Cosenza, Italy
| | - Giuseppe Musumeci
- Interventional Cardiology Unit, Azienda Ospedaliera Ordine Mauriziano di Torino, Torino, Italy
| | - Giovanni Esposito
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
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27
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Masiero G, Franzone A, Silvestri T, Castiglioni B, Greco F, La Manna AG, Limbruno U, Longoni M, Marchese A, Mattesini A, Mauro C, Rigattieri S, Tarantino FF, Esposito G, Musumeci G, Tarantini G. [PCSK9 inhibitor use in high cardiovascular risk patients: an interventionalist's overview on efficacy, current recommendations and factual prescription]. G Ital Cardiol (Rome) 2020; 21:264-270. [PMID: 32202557 DOI: 10.1714/3328.32985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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28
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Saia F, Bruno AG, Franzone A, Mojoli M, Mattesini A, Masiero G, Costa F, Rigattieri S, La Manna A, Castiglioni B, Limbruno U, Mauro C, Tarantino F, Musumeci G, Esposito G, Tarantini G. [Italian certification for interventional cardiologists from the Italian Society of Interventional Cardiology (SICI-GISE)]. G Ital Cardiol (Rome) 2020; 20:4S-7S. [PMID: 31593185 DOI: 10.1714/3219.31963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Differently from many European and non-European countries, currently in Italy there is not an official, well-defined process for training, evaluation and certification for interventional cardiologists. Interventional Cardiology is an important branch of Cardiology with peculiarities such as to need specific theoretical and practical training. The lack of standardization of training criteria may result in disparities in the quality of care offered to patients in different locations. The Italian Society of Interventional Cardiology (SICI-GISE) has therefore developed an independent certification process for Italian interventional cardiologists. This is a first step towards the implementation of a well-defined training and certification process for both coronary and structural interventions, and for regular re-certification of established operators.The certification will be issued by SICI-GISE and will be based on the recognition of the skills attained by interventional cardiologists in the setting of coronary diagnostic and interventional procedures. This document describes the minimum eligibility criteria for the training centers, which have the task of recording and validating the training activity carried out by each interventional cardiologist, and the minimum competence requirements that should be attained by the operators to obtain the certification.
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Affiliation(s)
- Francesco Saia
- U.O. Cardiologia, Dipartimento Cardio-Toraco-Vascolare, Policlinico S. Orsola-Malpighi, Azienda Ospedaliero-Universitaria di Bologna
| | - Antonio Giulio Bruno
- U.O. Cardiologia, Dipartimento Cardio-Toraco-Vascolare, Policlinico S. Orsola-Malpighi, Azienda Ospedaliero-Universitaria di Bologna
| | - Anna Franzone
- Cattedra di Malattie dell'Apparato Cardiovascolare, Dipartimento di Scienze Biomediche Avanzate, Università degli Studi "Federico II", Napoli
| | - Marco Mojoli
- Dipartimento di Scienze Cardiologiche, Toraciche, Vascolari, Università degli Studi, Padova
| | - Alessio Mattesini
- Interventistica Cardiologica Strutturale, Dipartimento Cardio-Toraco-Vascolare, AOU Careggi, Firenze
| | | | - Francesco Costa
- Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi, Messina
| | - Stefano Rigattieri
- U.O.S. Cardiologia Interventistica, Emodinamica ed Elettrostimolazione, AOU Sant'Andrea, Roma
| | - Alessio La Manna
- Divisione di Cardiologia, AOU Policlinico Vittorio Emanuele, Catania
| | | | - Ugo Limbruno
- U.O.C. Cardiologia, Ospedale Misericordia, Grosseto
| | - Ciro Mauro
- Dipartimento Cardiovascolare, Ospedale "Antonio Cardarelli", Napoli
| | - Fabio Tarantino
- U.O.S. Emodinamica Provinciale, Ospedale Bufalini, AUSL Romagna, Cesena
| | | | - Giovanni Esposito
- Cattedra di Malattie dell'Apparato Cardiovascolare, Dipartimento di Scienze Biomediche Avanzate, Università degli Studi "Federico II", Napoli
| | - Giuseppe Tarantini
- Dipartimento di Scienze Cardiologiche, Toraciche, Vascolari, Università degli Studi, Padova
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Mattesini A, Masiero G, Barbieri L, Vizzari G, Tarantino F, La Manna A, Mauro C, Limbruno U, Rigattieri S, Castiglioni B, Marchese A, Musumeci G, Tarantini G. [Dyslipidemia management for secondary prevention in cardiovascular disease: from guidelines to clinical practice]. G Ital Cardiol (Rome) 2020; 20:44S-49S. [PMID: 31593190 DOI: 10.1714/3219.31967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Despite improvements in the treatment and prevention of risk factors (i.e. dyslipidemia), cardiovascular disease (CVD) remains one of the leading causes of morbidity and mortality in countries with a high degree of socio-economic development. As a matter of fact, in the last decades, several trials and meta-analysis highlighted the impact of treatments targeted to lowering cholesterol levels (particularly LDL-cholesterol) on outcomes of patients affected by CVD, both in terms of primary and secondary prevention. The main international CVD guidelines recommend lifestyle modifications and optimal lipid-lowering therapy in individuals with established CVD. The aim of the present document is to describe the dimension of the problem and the available therapies, offering a practical pharmacological flow-chart useful for accurate monitoring and intensive treatment of dyslipidemias in this patient population.
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Affiliation(s)
| | | | | | - Giampiero Vizzari
- Ospedale "Giovanni Paolo II", ASP 7 Ragusa, Università degli Studi di Messina
| | | | - Alessio La Manna
- Centro Alte Specialità e Trapianti, Ospedale Gaspare Rodolico, Catania
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30
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Monistero V, Barberio A, Biscarini F, Cremonesi P, Castiglioni B, Graber HU, Bottini E, Ceballos-Marquez A, Kroemker V, Petzer IM, Pollera C, Santisteban C, Veiga Dos Santos M, Bronzo V, Piccinini R, Re G, Cocchi M, Moroni P. Different distribution of antimicrobial resistance genes and virulence profiles of Staphylococcus aureus strains isolated from clinical mastitis in six countries. J Dairy Sci 2020; 103:3431-3446. [PMID: 32008788 DOI: 10.3168/jds.2019-17141] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 12/03/2019] [Indexed: 11/19/2022]
Abstract
Staphylococcus aureus is recognized worldwide as one of the main contagious mastitis agents in cattle and can express a set of antimicrobial resistance genes and virulence-associated genes that explain the wide range of outcomes of intramammary infections. Staphylococcus aureus strains are heterogeneous: their different resistance and virulence patterns, associated with host-level factors and treatment factors, are related to the severity of infection. The aim of this study was to determine phenotypic antibiotic susceptibility, occurrence of selected antimicrobial resistance genes and other virulence genes in 93 S. aureus strains isolated from clinical mastitis in 6 countries: Argentina, Brazil, Germany, Italy, the United States (New York State), and South Africa. These isolates were tested against a total of 16 drugs (amoxicillin-clavulanate, ampicillin, cefazolin, cefoperazone, cefquinome, enrofloxacin, erythromycin, gentamicin, kanamycin, lincomycin, oxacillin, penicillin, rifampin, spiramycin, sulfamethoxazole/trimethoprim, tylosin) by minimum inhibitory concentration (MIC) assay, and examined for the presence of 6 antibiotic-resistance genes (blaZ, mecA, mecC, ermA, ermB, ermC) and 6 virulence-associated genes (scn, chp, sak, hla, hlb, sea) via PCR analysis. The phenotypic results of this study revealed the presence of 19.4% penicillin-resistant strains, whereas 22.6% of the strains were classified as having resistance (5.4%) or intermediate resistance (17.2%) to erythromycin. Most (96.8%) of the isolates were inhibited by cephalosporins, and all were susceptible to amoxicillin-clavulanate. Two strains (1 from Germany, 1 from Italy) were resistant to oxacillin and were positive for mecA. Among the other antimicrobial resistance genes, the most frequently detected was blaZ (46.2%), and 32.3% of the isolates were positive for erm genes: ermC (21.5%) and ermB (10.8%). The most prevalent virulence gene was hla (100%), followed by hlb (84.9%) and sea (65.6%). These results show a low prevalence of antibiotic multidrug resistance in S. aureus isolates, even if the detection of selected antimicrobial resistance genes did not always correspond with the occurrence of phenotypic antibiotic resistance; the immune evasion cluster gene prevalence was quite low in the samples analyzed.
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Affiliation(s)
- V Monistero
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, Italy, 20133
| | - A Barberio
- Istituto Zooprofilattico Sperimentale delle Venezie, Sezione Territoriale di Padova, Legnaro (PD), Italy, 3020
| | - F Biscarini
- Institute of Agricultural Biology and Biotechnology, National Research Council, Lodi, Italy, 26900
| | - P Cremonesi
- Institute of Agricultural Biology and Biotechnology, National Research Council, Lodi, Italy, 26900
| | - B Castiglioni
- Institute of Agricultural Biology and Biotechnology, National Research Council, Lodi, Italy, 26900
| | - H U Graber
- Agroscope, Research Division, Food Microbial Systems, Bern, Switzerland, 3003
| | - E Bottini
- Laboratorio de Microbiologia Clinica y Experimental, Departamento de Sanidad Animal y Medicina Preventiva SAMP/CIVENTAN, Becaria CONICET, Facultad de Ciencias Veterinarias, Universidad Nacional del Centro de la Provincia de Buenos Aires (FCV, UNCPBA), Paraje Arroyo Seco S/N, Campus Universitario, CP 7000 Tandil, Argentina
| | - A Ceballos-Marquez
- Laboratorio de Calidad de Leche y Epidemiología Veterinaria (Grupo CLEV), Universidad de 6 Caldas, Manizales, 170003, Colombia
| | - V Kroemker
- Bioprocess Engineering-Faculty II, Microbiology, University of Applied Sciences and Arts, 30453 Hannover, Germany
| | - I M Petzer
- Faculty of Veterinary Science, Onderstepoort, University of Pretoria, 0110, South Africa
| | - C Pollera
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, Italy, 20133
| | - C Santisteban
- Quality Milk Production Services, Animal Health Diagnostic Center, Cornell University, Ithaca, NY 14850
| | - M Veiga Dos Santos
- Department of Animal Nutrition and Production, School of Veterinary Medicine and Animal Sciences, Pirassununga-SP 13635900, Brazil
| | - V Bronzo
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, Italy, 20133
| | - R Piccinini
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, Italy, 20133
| | - G Re
- Università degli Studi di Torino, Dipartimento di Scienze Veterinarie, Turin, Italy, 10085
| | - M Cocchi
- Istituto Zooprofilattico Sperimentale delle Venezie, Sezione Territoriale di Udine, Basaldella di Campoformido (UD), Italy, 33030
| | - P Moroni
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, Italy, 20133; Quality Milk Production Services, Animal Health Diagnostic Center, Cornell University, Ithaca, NY 14850.
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31
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Tarantini G, Musumeci G, Esposito G, Mauro C, La Manna AG, Limbruno U, Tarantino FF, Castiglioni B, Rigattieri S, Longoni M, Marchese A, Masiero G, Mattesini A, Berti S, Saia F. [A strategic roadmap of the Italian Society of Interventional Cardiology (SICI-GISE) to ensure patient's access to appropriate treatment]. G Ital Cardiol (Rome) 2019; 20:4S-19S. [PMID: 30994629 DOI: 10.1714/3146.31274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In comparison with the international scenario, in Italy the penetration of several important scientific and technological innovations in the field of cardiovascular intervention appears to be inadequate both in terms of number of patients treated with respect to the actual need, and inhomogeneity between the different geographical areas of the country. One of the main institutional objectives of the Italian Society of Interventional Cardiology (SICI-GISE) is to develop a roadmap to guarantee homogeneous access throughout the whole national territory to treatments that are recommended by the major international guidelines. The present document focuses on four main areas of cardiovascular intervention: (i) transcatheter treatment of aortic valve stenosis, (ii) percutaneous mitral valve repair, (iii) prevention of cardioembolic stroke through percutaneous left atrial appendage occlusion in patients with non-valvular atrial fibrillation, (iv) optimization of coronary revascularization with the aid of the functional study of coronary lesions. The purpose of this document is to describe the clinical profile and the economic impact of the aforementioned methods, the current clinical, organizational and management barriers to treatment access in the national territory and the possible solutions for overcoming the aforementioned barriers.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Giulia Masiero
- A.O. Policlinico Universitario di Padova, Centro Gallucci, Padova
| | | | - Sergio Berti
- Ospedale del Cuore, Fondazione CNR Toscana G. Monasterio, Massa
| | - Francesco Saia
- A.O. Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna
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32
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Ferlini M, Rossini R, Musumeci G, Grieco N, Trabattoni D, Cornara S, Cardile A, Calchera I, Russo F, Ielasi A, Faggiano P, Castiglioni B, Lettieri C, Klersy C, Oltrona Visconti L. P5531A systematic follow-up strategy after percutaneous coronary intervention based on patient risk profile: the prospective POST-PCI registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Redundant clinical and non-invasive examinations after percutaneous coronary intervention (PCI) increase the cost of medical care with no outcome improve. A multidisciplinary consensus document (MCD) providing a follow-up (FU) strategy based on 3 clinical and angiographic risk profile (A high, B intermediate, and C low) has been recently proposed.
Aim
To evaluate the potential reduction of cardiologic consults (CC), stress tests (ST), and echocardiograms (EC) with the application of the MCD after PCI.
Methods
The Post-PCI registry is a multicenter, observational, prospective data collection carried out during a four-week period that included consecutive patients undergoing PCI at 31 Italian Hospitals both for acute coronary syndromes (ACS) or stable coronary artery disease (SCAD). FU strategies were left at investigator's discretion. A comparison between the CC, ST and EC performed in the first 12-months with the potential suggested by the MCD was evaluated.
Results
A total of 1113 patients were included; 12-months follow up was available in 90% of the cases (mean age 68±11 years old, 58% ACS). Based on MCD risk profile 17% were in A, 74% in B and 9% in C strategy. On average observed CC and ST were significantly lower compared to the expected based on MCD (respectively 1.63±1.07 vs 1.91±0.28, and 0.41±0.59 vs 0.61±0.84; on the contrary EC were significantly higher (0.64±0.73 vs 0.34±0.75, all: p<0.001). The excess rate for CC, ST and EC as compared to MCD was respectively 25%, 14% and 8% for the strategy A, 14%, 25% and 50% for the strategy B and 26%, 54% and 40% for the strategy C. At multivariable logistic analysis the MCD strategy was an independent predictor (in a model with age, sex, consulting physician, public or private hospital) of an increased number of cardiac examination in patients at intermediated and low risk [B group OR 2.56 (95% CI 1.38–4.75), C group 27.00 (95% CI 8.13–89.62)]. The other independent predictor was age, with a reduced number of examination for elderly (>75 years old) patients [OR 0.59 (CI 95% 0.43–0.80)].
Conclusion
Our data suggest that in a real word population of patients undergoing PCI, a follow-up strategy based on clinical and anatomical risk profile would allow to a reduction of cardiac tests and consultations, particularly in patients at intermediated and low risk leading to an increase of appropriateness of prescription and to a cost reduction of medical care.
Acknowledgement/Funding
The Post-PCI registry was supported by the Italian Society of Interventional Cardiology (SICI-GISE) receiving an unrestricted grant from Astra Zeneca
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Affiliation(s)
- M Ferlini
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - R Rossini
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - G Musumeci
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - N Grieco
- Niguarda Ca' Granda Hospital, Milan, Italy
| | | | - S Cornara
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - A Cardile
- AO Ospedale Treviglio, Treviglio, Italy
| | | | - F Russo
- Sant'Anna Hospital, Como, Italy
| | - A Ielasi
- Bolognini Hospital, Seriate, Italy
| | - P Faggiano
- Civil Hospital of Brescia, Brescia, Italy
| | | | | | - C Klersy
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - L Oltrona Visconti
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
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33
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Sciahbasi A, Piccaluga E, Andreassi MG, Trianni A, Rosi A, Sarandrea A, Longoni M, Germinal F, Santucci S, Bernardi G, Rigattieri S, La Manna A, Castiglioni B, Limbruno U, Mauro C, Tarantino F, Esposito G, Musumeci G, Tarantini G. [SICI-GISE Position paper: Enhancing radiation safety in the catheterization laboratory]. G Ital Cardiol (Rome) 2019; 20:14S-28S. [PMID: 31593188 DOI: 10.1714/3219.31965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The radiation dose received by interventional cardiologists during their activity in the catheterization laboratory is a matter of concern in terms of possible deterministic and stochastic risk. At the same time, very often, the knowledge of the effect and consequences of radiation exposure in the interventional cardiology community is limited. This document endorsed by the Italian Society of Interventional Cardiology (SICI-GISE) provides recommendations for cardiologists' radiation protection. Radiation safety considerations dedicated to women and other staff personnel working in the catheterization laboratory are also discussed.
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Affiliation(s)
| | - Emanuela Piccaluga
- Cardiologia-Emodinamica, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | | | | | - Antonella Rosi
- Centro Nazionale delle Tecnologie Innovative per la Sanità Pubblica, Istituto Superiore di Sanità, Roma
| | | | - Matteo Longoni
- Emodinamica e Cardiologia Interventistica, Ospedale San Raffaele, Milano
| | - Francesco Germinal
- U.O.C. Cardiologia Interventistica ed Emodinamica, Ospedale "Vito Fazzi", Lecce
| | - Stefano Santucci
- U.O.S. Cardiologia Interventistica, Emodinamica ed Elettrostimolazione, AOU Sant'Andrea, Roma
| | | | - Stefano Rigattieri
- U.O.S. Cardiologia Interventistica, Emodinamica ed Elettrostimolazione, AOU Sant'Andrea, Roma
| | - Alessio La Manna
- Dipartimento Cardio-Toraco-Vascolare, AOU Policlinico "Vittorio Emanuele", Catania
| | | | - Ugo Limbruno
- U.O.C. Cardiologia, Ospedale Misericordia, Grosseto
| | - Ciro Mauro
- U.O.C. Cardiologia, Ospedale Cardarelli, Napoli
| | | | | | | | - Giuseppe Tarantini
- Dipartimento di Scienze Cardiache, Toraciche e Vascolari, Policlinico Universitario di Padova
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Saia F, Bruno AG, Franzone A, Mojoli M, Mattesini A, Masiero G, Costa F, Rigattieri S, La Manna A, Castiglioni B, Limbruno U, Mauro C, Tarantino F, Musumeci G, Esposito G, Tarantini G. [Online Addenda: Italian certification for interventional cardiologists from the Italian Society of Interventional Cardiology (SICI-GISE)]. G Ital Cardiol (Rome) 2019; 20:0. [PMID: 31593186 DOI: 10.1714/3219.31969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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35
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Amadori M, Addis MF, Bronzo V, Castiglioni B, Moroni P, Piccinini R. A reply to the comment on "control of bovine mastitis in the 21st century: Immunize or tolerize?" by Fernando N. Souza and co-workers. Res Vet Sci 2019; 126:1-3. [PMID: 31415927 DOI: 10.1016/j.rvsc.2019.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 08/05/2019] [Accepted: 08/05/2019] [Indexed: 10/26/2022]
Affiliation(s)
- M Amadori
- Laboratory of Animal Welfare, Clinical Chemistry and Veterinary Immunology, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna, Brescia, Italy.
| | - M F Addis
- Università degli Studi di Milano, Department of Veterinary Medicine, Milan, Italy
| | - V Bronzo
- Università degli Studi di Milano, Department of Veterinary Medicine, Milan, Italy
| | - B Castiglioni
- Istituto di Biologia e Biotecnologia Agraria, Consiglio Nazionale delle Ricerche, Lodi, Italy
| | - P Moroni
- Università degli Studi di Milano, Department of Veterinary Medicine, Milan, Italy
| | - R Piccinini
- Università degli Studi di Milano, Department of Veterinary Medicine, Milan, Italy
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36
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Filipe J, Bronzo V, Curone G, Castiglioni B, Vigo D, Smith B, Herrera V, Roccabianca P, Moroni P, Riva F. Staphylococcus aureus intra-mammary infection affects the expression pattern of IL-R8 in goat. Comp Immunol Microbiol Infect Dis 2019; 66:101339. [PMID: 31437679 DOI: 10.1016/j.cimid.2019.101339] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 07/24/2019] [Accepted: 07/26/2019] [Indexed: 01/23/2023]
Abstract
IL-1R8 is a member of Interleukin-1 receptor family acting as a negative regulator of inflammation reliant on ILRs and TLRs activation. IL-1R8 role has never been evaluated in acute bacterial mastitis. We first investigated IL-1R8 sequence conservation among different species and its pattern of expression in a wide panel of organs from healthy goats. Then, modulation of IL-1R8 during natural and experimental mammary infection was evaluated and compared in blood, milk and mammary tissues from healthy and Staphylococcus aureus infected goats. IL-1R8 has a highly conserved sequence among vertebrates. Goat IL-1R8 was ubiquitously expressed in epithelial and lymphoid tissues with highest levels in pancreas. IL-1R8 was down-regulated in epithelial mammary cells following S. aureus infection. Interestingly it was up-regulated in leukocytes infiltrating the infected mammary tissues suggesting that it could represent a target of S. aureus immune evasion.
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Affiliation(s)
- J Filipe
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, via Celoria 10, 20133, Milan, Italy.
| | - V Bronzo
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, via Celoria 10, 20133, Milan, Italy.
| | - G Curone
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, via Celoria 10, 20133, Milan, Italy.
| | - B Castiglioni
- Istituto di Biologia e Biotecnologia Agraria, Consiglio Nazionale delle Ricerche, 26900, Lodi, Italy.
| | - D Vigo
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, via Celoria 10, 20133, Milan, Italy.
| | - B Smith
- University of California, Davis, Wildlife Health Center, Davis, CA 95616, USA.
| | - V Herrera
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, via Celoria 10, 20133, Milan, Italy.
| | - P Roccabianca
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, via Celoria 10, 20133, Milan, Italy.
| | - P Moroni
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, via Celoria 10, 20133, Milan, Italy; Cornell University, Animal Health Diagnostic Center, Quality Milk Production Services, Ithaca, NY 14853, USA.
| | - F Riva
- Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, via Celoria 10, 20133, Milan, Italy.
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37
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Ferlini M, Rossini R, Musumeci G, Grieco N, Demarchi A, Trabattoni D, Zavalloni Parenti D, Pierini S, Castiglioni B, Somaschini A, Cornara S, Lettieri C, Oltrona Visconti L. Perceived or Calculated Bleeding Risk and Their Relation With Dual Antiplatelet Therapy Duration in Patients Undergoing Percutaneous Coronary Intervention. Circ Cardiovasc Interv 2019; 12:e007949. [PMID: 31142150 DOI: 10.1161/circinterventions.119.007949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Marco Ferlini
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy (M.F., A.D., L.O.V.)
| | - Roberta Rossini
- Division of Cardiology, Ospedale Santa Croce e Carle, Cuneo, Italy (R.R., G.M.)
| | - Giuseppe Musumeci
- Division of Cardiology, Ospedale Santa Croce e Carle, Cuneo, Italy (R.R., G.M.)
| | - Niccolò Grieco
- Cardiology-Hemodynamics Department, Niguarda Ca'Granda Hospital (N.G.)
| | - Andrea Demarchi
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy (M.F., A.D., L.O.V.)
| | - Daniela Trabattoni
- Department of Cardiovascular Sciences, Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.T.)
| | | | - Simona Pierini
- Interventional Cardiology Unit, ASST Nord Milano, Ospedale Edoardo Bassini, Cinisello Balsamo, Italy (S.P.)
| | - Battistina Castiglioni
- U.O.C. Cardiologia 2, Cardiologia Interventistica, ASST Sette Laghi, Varese, Italy (B.C.)
| | - Alberto Somaschini
- Department of Molecular Medicine, Unit of Cardiology, University of Pavia, Italy (A.S., S.C.)
| | - Stefano Cornara
- Department of Molecular Medicine, Unit of Cardiology, University of Pavia, Italy (A.S., S.C.)
| | - Corrado Lettieri
- Department of Cardiology, ASST Mantova-Ospedale Carlo Poma, Italy (C.L.)
| | - Luigi Oltrona Visconti
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy (M.F., A.D., L.O.V.)
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38
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Russo A, Lettieri C, Caico SI, Musumeci G, Rossini R, Castiglioni B. [Spontaneous coronary artery dissections]. G Ital Cardiol (Rome) 2018; 19:488-494. [PMID: 30087509 DOI: 10.1714/2951.29667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Spontaneous coronary artery dissection (SCAD) is a non-atherosclerotic coronary artery pathology and an important cause of coronary artery disease in young women with an average age of 40 to 50 years with few or no cardiovascular risk factors. There has been a surge in the diagnosis of SCAD due to an increased use of coronary angiography and the clinical availability and application of high-resolution intracoronary imaging. SCAD is due to the separation of coronary wall layers with the formation of intramural hematoma, compression of the true lumen and secondary myocardial ischemia. Coronary angiography is the first-line imaging, also useful are intravascular ultrasound and optical coherence tomography. Therapy is conservative in most cases because of the high percentage of spontaneous healing of the vascular wall. The prognosis is good, although the disease is burdened by a high prevalence of major adverse coronary events, including recurrence of coronary dissection, thus making careful follow-up essential in survivors of the acute event. Given that the presence of SCAD may be associated with aneurysm formation and dissections of other arteries, screening of the arterial tree may be useful, especially of the supra-aortic trunks and splanchnic circulation.
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Affiliation(s)
- Alessandra Russo
- Cardiologia Interventistica, ASST Valle Olona, Presidio di Gallarate (VA)
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39
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Tarantini G, Esposito G, Musumeci G, Fraccaro C, Franzone A, Castiglioni B, La Manna A, Limbruno U, Marchese A, Mauro C, Rigattieri S, Tarantino F, Gandolfo C, Santoro G, Violini R, Airoldi F, Albiero R, Balbi M, Baralis G, Bartorelli AL, Bedogni F, Benassi A, Berni A, Bonzani G, Bortone AS, Braito G, Briguori C, Brscic E, Calabrò P, Calchera I, Cappelli Bigazzi M, Caprioglio F, Castriota F, Cernetti C, Cicala C, Cioffi P, Colombo A, Colombo V, Contegiacomo G, Cremonesi A, D'Amico M, De Benedictis M, De Leo A, Di Biasi M, Di Girolamo D, Di Lorenzo E, Di Mario C, Dominici M, Ettori F, Ferrario M, Fioranelli M, Fischetti D, Gabrielli G, Giordano A, Giudice P, Greco C, Indolfi C, Leonzi O, Lettieri C, Loi B, Maddestra N, Marchionni N, Marrozzini C, Medda M, Missiroli B, My L, Oreglia JA, Palmieri C, Pantaleo P, Paparoni SR, Parodi G, Petronio AS, Piatti L, Piccaluga E, Pierli C, Perkan A, Pitì A, Poli A, Ramondo AB, Reale MA, Reimers B, Ribichini FL, Rosso R, Saccà S, Sacra C, Santarelli A, Sardella G, Satullo G, Scalise F, Siviglia M, Spedicato L, Stabile A, Tamburino C, Tesorio TNM, Tolaro S, Tomai F, Trani C, Valenti R, Valsecchi O, Valva G, Varbella F, Vigna C, Vignali L, Berti S. [Updated SICI-GISE position paper on institutional and operator requirements for transcatheter aortic valve implantation]. G Ital Cardiol (Rome) 2018; 19:519-529. [PMID: 30087514 DOI: 10.1714/2951.29672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Transcatheter aortic valve implantation (TAVI) has revolutionized the management of patients with symptomatic severe aortic stenosis and has become the standard of care for inoperable patients and the preferred therapy for those at increased surgical risk with peculiar clinical and anatomic features. Technology advances, growing experience and accumulating data prompted the update of the 2011 Italian Society of Interventional Cardiology (SICI-GISE) position paper on institutional and operator requirements to perform TAVI. The main objective of this document is to provide a guidance to assess the potential of institutions and operators to initiate and maintain an efficient TAVI program.
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Affiliation(s)
| | | | | | - Chiara Fraccaro
- A.O. Policlinico Universitario di Padova, Centro Gallucci, Padova
| | | | | | - Alessio La Manna
- Cardiologia Centro Alte Specialità e Trapianti, Ospedale Gaspare Rodolico, Catania
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ciro Indolfi
- Policlinico Universitario Mater Domini, Catanzaro
| | | | | | | | | | | | - Cinzia Marrozzini
- A.O. Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna
| | | | | | - Luigi My
- Casa di Cura Villa Verde, Taranto
| | | | | | | | | | | | | | | | | | | | - Andrea Perkan
- Azienda Sanitaria Universitaria Integrata di Trieste, Ospedale di Cattinara, Trieste
| | | | | | | | | | | | | | | | | | - Cosimo Sacra
- Università Cattolica del Sacro Cuore, Campobasso
| | | | | | | | | | | | | | | | - Corrado Tamburino
- Cardiologia Centro Alte Specialità e Trapianti, Ospedale Gaspare Rodolico, Catania
| | | | | | | | - Carlo Trani
- Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Roma
| | | | | | | | | | - Carlo Vigna
- Ospedale Casa Sollievo della Sofferenza, IRCCS, San Giovanni Rotondo (FG)
| | | | - Sergio Berti
- Ospedale del Cuore, Fondazione CNR Toscana G. Monasterio, Pisa
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Ferlini M, Musumeci G, Grieco N, Rossini R, Demarchi A, Cornara S, Somaschini A, Trabattoni D, Zavalloni Parenti D, Martinoni A, Castiglioni B, Faggiano P, Oliva F, Lettiieri C, Oltrona Visconti L. 2228Are perceived or calculated bleeding risk related to dapt choice in patients undergoing percutaneous coronary intervention? Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.2228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Ferlini
- Policlinic Foundation San Matteo IRCCS, Pavia, Italy
| | - G Musumeci
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - N Grieco
- Niguarda Ca' Granda Hospital, Milan, Italy
| | - R Rossini
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - A Demarchi
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - S Cornara
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - A Somaschini
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | | | | | | | | | - P Faggiano
- Civil Hospital of Brescia, Brescia, Italy
| | - F Oliva
- Niguarda Ca' Granda Hospital, Milan, Italy
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41
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Musumeci G, Faggiano P, Ferlini M, Lettieri C, Castiglioni B, Maggi A, Negri F, Colombo P, Oliva F, Pedretti RFE, Centola M, Rossini R. [Follow-up strategies after percutaneous coronary intervention: prognostic stratification and multidisciplinary management based on patient risk profile]. G Ital Cardiol (Rome) 2017; 18:3-12. [PMID: 28492563 DOI: 10.1714/2655.27229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The number of percutaneous coronary interventions (PCI) is increasing worldwide. Follow-up strategies after PCI are extremely heterogeneous and can greatly affect the cost of medical care. In the present paper, practical advises are provided with respect to a tailored follow-up strategy on the basis of patients' risk profile. Clinical and interventional cardiologists, cardiac rehabilitators, and general practitioners equally contributed to the creation of the present document and defined three follow-up strategies and types and timing of clinical and instrumental evaluations in post-PCI patients.
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Affiliation(s)
| | | | - Marco Ferlini
- S.C. Cardiologia, Fondazione IRCCS Policlinico San Matteo, Pavia
| | | | | | | | - Fabrizio Negri
- Medico di Medicina Generale, Distretto di Casteggio - convenzionato ASL, Pavia
| | - Paola Colombo
- Cardiologia 1 - Emodinamica, Dipartimento Cardiovascolare, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Fabrizio Oliva
- Cardiologia 1 - Emodinamica, Dipartimento Cardiovascolare, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Roberto F E Pedretti
- U.O. Cardiologia, IRCCS Fondazione Salvatore Maugeri, Istituto Scientifico di Tradate, Tradate (VA)
| | - Marco Centola
- Divisione di Cardiologia, A.O. San Paolo, Polo Universitario, Milano
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Capra E, Cremonesi P, Pietrelli A, Puccio S, Luini M, Stella A, Castiglioni B. Genomic and transcriptomic comparison between Staphylococcus aureus strains associated with high and low within herd prevalence of intra-mammary infection. BMC Microbiol 2017; 17:21. [PMID: 28103794 PMCID: PMC5247818 DOI: 10.1186/s12866-017-0931-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 01/12/2017] [Indexed: 01/25/2023] Open
Abstract
Background Staphylococcus aureus (Staph. aureus) is one of the major pathogens causing mastitis in dairy ruminants worldwide. The chronic nature of Staph. aureus infection enhances the contagiousness risk and diffusion in herds. In order to identify the factors involved in intra-mammary infection (IMI) and diffusion in dairy cows, we investigated the molecular characteristics of two groups of Staph. aureus strains belonging to ST8 and ST398, differing in clinical properties, through comparison of whole genome and whole transcriptome sequencing. Results The two groups of strains, one originated from high IMI prevalence herds and the other from low IMI prevalence herds, present a peculiar set of genes and polymorphisms related to phenotypic features, such as bacterial invasion of mammary epithelial cells and host adaptation. Transcriptomic analysis supports the high propensity of ST8 strain to chronicity of infection and to a higher potential cytotoxicity. Conclusions Our data are consistent with the invasiveness and host adaptation feature for the strains GTB/ST8 associated to high within-herd prevalence of mastitis. Variation in genes coding for surface exposed proteins and those associated to virulence and defence could constitute good targets for further research. Electronic supplementary material The online version of this article (doi:10.1186/s12866-017-0931-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- E Capra
- Istituto di Biologia e Biotecnologia Agraria, CNR, via Einstein, 26900, Lodi, Italy.
| | - P Cremonesi
- Istituto di Biologia e Biotecnologia Agraria, CNR, via Einstein, 26900, Lodi, Italy
| | - A Pietrelli
- Istituto di Tecnologie Biomediche, CNR, Via Fratelli Cervi 93, 20090, Segrate, Milano, Italy.,Istituto Nazionale di Genetica Molecolare "Romeo ed Enrica Invernizzi", Via Francesco Sforza 35, 20122, Milan, Italy
| | - S Puccio
- Istituto di Tecnologie Biomediche, CNR, Via Fratelli Cervi 93, 20090, Segrate, Milano, Italy.,Scuola di Dottorato in Medicina Molecolare e Traslazionale, Università di Milano, Segrate, Milan, 20009, Italy
| | - M Luini
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia, Sezione di Lodi, via Einstein, 26900, Lodi, Italy
| | - A Stella
- Istituto di Biologia e Biotecnologia Agraria, CNR, via Einstein, 26900, Lodi, Italy.,Parco Tecnologico Padano, Via Einstein, 26900, Lodi, Italy
| | - B Castiglioni
- Istituto di Biologia e Biotecnologia Agraria, CNR, via Einstein, 26900, Lodi, Italy
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Wolff G, Dimitroulis D, Andreotti F, Kołodziejczak M, Jung C, Scicchitano P, Devito F, Zito A, Occhipinti M, Castiglioni B, Calveri G, Maisano F, Ciccone MM, De Servi S, Navarese EP. Survival Benefits of Invasive Versus Conservative Strategies in Heart Failure in Patients With Reduced Ejection Fraction and Coronary Artery Disease. Circ Heart Fail 2017; 10:CIRCHEARTFAILURE.116.003255. [PMID: 28087687 DOI: 10.1161/circheartfailure.116.003255] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 12/05/2016] [Indexed: 01/06/2023]
Abstract
Background—
Heart failure with reduced ejection fraction caused by ischemic heart disease is associated with increased morbidity and mortality. It remains unclear whether revascularization by either coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) carries benefits or risks in this group of stable patients compared with medical treatment.
Methods and Results—
We performed a meta-analysis of available studies comparing different methods of revascularization (PCI or CABG) against each other or medical treatment in patients with coronary artery disease and left ventricular ejection fraction ≤40%. The primary outcome was all-cause mortality; myocardial infarction, revascularization, and stroke were also analyzed. Twenty-one studies involving a total of 16 191 patients were included. Compared with medical treatment, there was a significant mortality reduction with CABG (hazard ratio, 0.66; 95% confidence interval, 0.61–0.72;
P
<0.001) and PCI (hazard ratio, 0.73; 95% confidence interval, 0.62–0.85;
P
<0.001). When compared with PCI, CABG still showed a survival benefit (hazard ratio, 0.82; 95% confidence interval, 0.75–0.90;
P
<0.001).
Conclusions—
The present meta-analysis indicates that revascularization strategies are superior to medical treatment in improving survival in patients with ischemic heart disease and reduced ejection fraction. Between the 2 revascularization strategies, CABG seems more favorable compared with PCI in this particular clinical setting.
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Affiliation(s)
- Georg Wolff
- From the Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE Research Network, Milan, Italy (G.W., D.D., F.A., M.K., C.J., P.S., F.D., A.Z., M.O., M.M.C., S.D.S., E.P.N.); Department of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, Düsseldorf, Germany (G.W., D.D., C.J.); Institute of Cardiology, Catholic University, Rome, Italy (F.A.); Collegium Medicum in Bydgoszcz, University of Nicolaus Copernicus, Toruń,
| | - Dimitrios Dimitroulis
- From the Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE Research Network, Milan, Italy (G.W., D.D., F.A., M.K., C.J., P.S., F.D., A.Z., M.O., M.M.C., S.D.S., E.P.N.); Department of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, Düsseldorf, Germany (G.W., D.D., C.J.); Institute of Cardiology, Catholic University, Rome, Italy (F.A.); Collegium Medicum in Bydgoszcz, University of Nicolaus Copernicus, Toruń,
| | - Felicita Andreotti
- From the Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE Research Network, Milan, Italy (G.W., D.D., F.A., M.K., C.J., P.S., F.D., A.Z., M.O., M.M.C., S.D.S., E.P.N.); Department of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, Düsseldorf, Germany (G.W., D.D., C.J.); Institute of Cardiology, Catholic University, Rome, Italy (F.A.); Collegium Medicum in Bydgoszcz, University of Nicolaus Copernicus, Toruń,
| | - Michalina Kołodziejczak
- From the Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE Research Network, Milan, Italy (G.W., D.D., F.A., M.K., C.J., P.S., F.D., A.Z., M.O., M.M.C., S.D.S., E.P.N.); Department of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, Düsseldorf, Germany (G.W., D.D., C.J.); Institute of Cardiology, Catholic University, Rome, Italy (F.A.); Collegium Medicum in Bydgoszcz, University of Nicolaus Copernicus, Toruń,
| | - Christian Jung
- From the Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE Research Network, Milan, Italy (G.W., D.D., F.A., M.K., C.J., P.S., F.D., A.Z., M.O., M.M.C., S.D.S., E.P.N.); Department of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, Düsseldorf, Germany (G.W., D.D., C.J.); Institute of Cardiology, Catholic University, Rome, Italy (F.A.); Collegium Medicum in Bydgoszcz, University of Nicolaus Copernicus, Toruń,
| | - Pietro Scicchitano
- From the Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE Research Network, Milan, Italy (G.W., D.D., F.A., M.K., C.J., P.S., F.D., A.Z., M.O., M.M.C., S.D.S., E.P.N.); Department of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, Düsseldorf, Germany (G.W., D.D., C.J.); Institute of Cardiology, Catholic University, Rome, Italy (F.A.); Collegium Medicum in Bydgoszcz, University of Nicolaus Copernicus, Toruń,
| | - Fiorella Devito
- From the Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE Research Network, Milan, Italy (G.W., D.D., F.A., M.K., C.J., P.S., F.D., A.Z., M.O., M.M.C., S.D.S., E.P.N.); Department of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, Düsseldorf, Germany (G.W., D.D., C.J.); Institute of Cardiology, Catholic University, Rome, Italy (F.A.); Collegium Medicum in Bydgoszcz, University of Nicolaus Copernicus, Toruń,
| | - Annapaola Zito
- From the Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE Research Network, Milan, Italy (G.W., D.D., F.A., M.K., C.J., P.S., F.D., A.Z., M.O., M.M.C., S.D.S., E.P.N.); Department of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, Düsseldorf, Germany (G.W., D.D., C.J.); Institute of Cardiology, Catholic University, Rome, Italy (F.A.); Collegium Medicum in Bydgoszcz, University of Nicolaus Copernicus, Toruń,
| | - Michele Occhipinti
- From the Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE Research Network, Milan, Italy (G.W., D.D., F.A., M.K., C.J., P.S., F.D., A.Z., M.O., M.M.C., S.D.S., E.P.N.); Department of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, Düsseldorf, Germany (G.W., D.D., C.J.); Institute of Cardiology, Catholic University, Rome, Italy (F.A.); Collegium Medicum in Bydgoszcz, University of Nicolaus Copernicus, Toruń,
| | - Battistina Castiglioni
- From the Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE Research Network, Milan, Italy (G.W., D.D., F.A., M.K., C.J., P.S., F.D., A.Z., M.O., M.M.C., S.D.S., E.P.N.); Department of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, Düsseldorf, Germany (G.W., D.D., C.J.); Institute of Cardiology, Catholic University, Rome, Italy (F.A.); Collegium Medicum in Bydgoszcz, University of Nicolaus Copernicus, Toruń,
| | - Giuseppe Calveri
- From the Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE Research Network, Milan, Italy (G.W., D.D., F.A., M.K., C.J., P.S., F.D., A.Z., M.O., M.M.C., S.D.S., E.P.N.); Department of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, Düsseldorf, Germany (G.W., D.D., C.J.); Institute of Cardiology, Catholic University, Rome, Italy (F.A.); Collegium Medicum in Bydgoszcz, University of Nicolaus Copernicus, Toruń,
| | - Francesco Maisano
- From the Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE Research Network, Milan, Italy (G.W., D.D., F.A., M.K., C.J., P.S., F.D., A.Z., M.O., M.M.C., S.D.S., E.P.N.); Department of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, Düsseldorf, Germany (G.W., D.D., C.J.); Institute of Cardiology, Catholic University, Rome, Italy (F.A.); Collegium Medicum in Bydgoszcz, University of Nicolaus Copernicus, Toruń,
| | - Marco M. Ciccone
- From the Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE Research Network, Milan, Italy (G.W., D.D., F.A., M.K., C.J., P.S., F.D., A.Z., M.O., M.M.C., S.D.S., E.P.N.); Department of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, Düsseldorf, Germany (G.W., D.D., C.J.); Institute of Cardiology, Catholic University, Rome, Italy (F.A.); Collegium Medicum in Bydgoszcz, University of Nicolaus Copernicus, Toruń,
| | - Stefano De Servi
- From the Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE Research Network, Milan, Italy (G.W., D.D., F.A., M.K., C.J., P.S., F.D., A.Z., M.O., M.M.C., S.D.S., E.P.N.); Department of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, Düsseldorf, Germany (G.W., D.D., C.J.); Institute of Cardiology, Catholic University, Rome, Italy (F.A.); Collegium Medicum in Bydgoszcz, University of Nicolaus Copernicus, Toruń,
| | - Eliano P. Navarese
- From the Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE Research Network, Milan, Italy (G.W., D.D., F.A., M.K., C.J., P.S., F.D., A.Z., M.O., M.M.C., S.D.S., E.P.N.); Department of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, Düsseldorf, Germany (G.W., D.D., C.J.); Institute of Cardiology, Catholic University, Rome, Italy (F.A.); Collegium Medicum in Bydgoszcz, University of Nicolaus Copernicus, Toruń,
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Locatelli C, Cremonesi P, Caprioli A, Carfora V, Ianzano A, Barberio A, Morandi S, Casula A, Castiglioni B, Bronzo V, Moroni P. Occurrence of methicillin-resistant Staphylococcus aureus in dairy cattle herds, related swine farms, and humans in contact with herds. J Dairy Sci 2016; 100:608-619. [PMID: 27865508 DOI: 10.3168/jds.2016-11797] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 09/25/2016] [Indexed: 12/16/2022]
Abstract
In this study we investigated the circulation of methicillin-resistant Staphylococcus aureus (MRSA) in 2 dairy cattle farms (farm A and B), previously identified as MRSA-positive in bulk tank milk samples, and epidemiologically related to swine farms. Collected specimens included quarter milk samples and nasal swabs from dairy cows, pig nasal swabs collected at both the farm and slaughterhouse level, environmental dust samples, and human nasal swabs from the farms' owners and workers. The prevalence of MRSA was estimated at the herd level by testing quarter milk samples. The prevalence of MRSA was 4.8% (3/63; 95% confidence interval=0-10.2%) and 60% (33/55; 95% confidence interval=47.05-72.95) in farm A and B, respectively. In farm A, MRSA was also isolated from humans, pigs sampled at both farm and slaughterhouse level, and from environmental samples collected at the pig facilities. The dairy cattle facilities of farm A tested negative for MRSA. In farm B, MRSA was isolated from environmental dust samples in both the cattle and pig facilities, whereas nasal swabs collected from cows and from humans tested negative. Sixty-three selected MRSA isolates obtained from different sources in farm A and B were genetically characterized by multilocus sequence typing, spa-typing, ribosomal spacer-PCR, and also tested for the presence of specific virulence genes and for their phenotypical antimicrobial susceptibility by broth microdilution method. Different clonal complex (CC) and spa-types were identified, including CC398, CC97, and CC1, CC already reported in livestock animals in Italy. The MRSA isolates from quarter milk of farm A and B mostly belonged to CC97 and CC398, respectively. Both lineages were also identified in humans in farm A. The CC97 and CC398 quarter milk isolates were also identified as genotype GTBE and GTAF by ribosomal spacer-PCR respectively, belonging to distinct clusters with specific virulence and resistance patterns. The GTBE and GTAF clusters also included swine, environmental, and human isolates from both farms. A high heterogeneity in the genetic and phenotypic profiles was observed in environmental isolates, in particular from farm B. These results demonstrate the possibility of a dynamic sharing and exchange of MRSA lineages or genotypes between different species and farm compartments in mixed-species farms. The risk of transmission between swine and related dairy cattle herds should be considered. Our findings also confirm the zoonotic potential of livestock-associated MRSA and underline the importance of applying biosecurity measures and good hygiene practices to prevent MRSA spread at the farm level and throughout the food production chain.
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Affiliation(s)
- C Locatelli
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare, Università degli Studi di Milano, 20133 Milan, Italy
| | - P Cremonesi
- Istituto di Biologia e Biotecnologia Agraria, (IBBA-CNR), via Einstein, 26900 Lodi, Italy
| | - A Caprioli
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri" General Diagnostic Department, National Reference Laboratory for Antimicrobial Resistance, Via Appia Nuova 1411, 00178 Rome, Italy
| | - V Carfora
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri" General Diagnostic Department, National Reference Laboratory for Antimicrobial Resistance, Via Appia Nuova 1411, 00178 Rome, Italy
| | - A Ianzano
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri" General Diagnostic Department, National Reference Laboratory for Antimicrobial Resistance, Via Appia Nuova 1411, 00178 Rome, Italy
| | - A Barberio
- Istituto Zooprofilattico Sperimentale delle Venezie, Vicenza viale Fiume 78, 36100 Vicenza, Italy
| | - S Morandi
- Istituto di Scienze delle Produzioni Alimentari, (ISPA-CNR), via Celoria 2, 20133 Milan, Italy
| | - A Casula
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, 20133 Milan, Italy
| | - B Castiglioni
- Istituto di Biologia e Biotecnologia Agraria, (IBBA-CNR), via Einstein, 26900 Lodi, Italy
| | - V Bronzo
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, 20133 Milan, Italy
| | - P Moroni
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, 20133 Milan, Italy; Animal Heath Diagnostic Center, Quality Milk Production Services, Cornell University, Ithaca, NY 14853.
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Tebaldi G, Jacca S, Montanini B, Capra E, Rosamilia A, Sala A, Stella A, Castiglioni B, Ottonello S, Donofrio G. Virus-Mediated Metalloproteinase 1 Induction Revealed by Transcriptome Profiling of Bovine Herpesvirus 4-Infected Bovine Endometrial Stromal Cells. Biol Reprod 2016; 95:12. [DOI: 10.1095/biolreprod.116.139097] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 05/13/2016] [Indexed: 11/01/2022] Open
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Iacuaniello S, Castiglioni B, Gorni C, Stella A, Mariani P, Pagnacco G. Microarray analyses to identify differentially expressed genes for assessing meat quality in swine. Italian Journal of Animal Science 2016. [DOI: 10.4081/ijas.2007.1s.144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- S. Iacuaniello
- Dipartimento di Scienze e Tecnologie Veterinarie per la Sicurezza Alimentare, Università di Milano, Italy
| | - B. Castiglioni
- Istituto di Biologia e Biotecnologia Agraria. Consiglio Nazionale delle Ricerche, University of Natural Resources and Applied Sciences, Milano, Italy
| | - C. Gorni
- Livestock Genomics, Parco Tecnologico Padano, Lodi, Israel
| | - A. Stella
- Livestock Genomics, Parco Tecnologico Padano, Lodi, Israel
| | - P. Mariani
- Livestock Genomics, Parco Tecnologico Padano, Lodi, Israel
| | - G. Pagnacco
- Dipartimento di Scienze e Tecnologie Veterinarie per la Sicurezza Alimentare, Università di Milano, Italy
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Locatelli C, Cremonesi P, Bertocchi L, Zanoni M, Barberio A, Drigo I, Varisco G, Castiglioni B, Bronzo V, Moroni P. Short communication: Methicillin-resistant Staphylococcus aureus in bulk tank milk of dairy cows and effect of swine population density. J Dairy Sci 2016; 99:2151-2156. [DOI: 10.3168/jds.2015-9940] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 11/07/2015] [Indexed: 11/19/2022]
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Cremonesi P, Pozzi F, Raschetti M, Bignoli G, Capra E, Graber HU, Vezzoli F, Piccinini R, Bertasi B, Biffani S, Castiglioni B, Luini M. Genomic characteristics of Staphylococcus aureus strains associated with high within-herd prevalence of intramammary infections in dairy cows. J Dairy Sci 2015; 98:6828-38. [PMID: 26233457 DOI: 10.3168/jds.2014-9074] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 06/09/2015] [Indexed: 11/19/2022]
Abstract
Staphylococcus aureus is one of the most important causes of mastitis in dairy cattle. Based on previous research, Staph. aureus genotypes with different pathogenic and contagious properties can cause intramammary infection (IMI) and coexist in the same herd. Our study aimed to compare Staph. aureus strains from herds that differed in IMI prevalence using different molecular approaches such as ribosomal spacer (RS)-PCR, multilocus sequence typing (MLST), spa typing, ribotyping, pulsed-field gel electrophoresis (PFGE), and multiplex PCR. For this purpose, 31 dairy herds with Staph. aureus IMI were selected, and 16 of these were chosen for a comparison study: the 8 high-prevalence (HP) herds had Staph. aureus IMI prevalence >28% and the 8 low-prevalence (LP) herds had an IMI prevalence <4%. A total of 650 isolates of Staph. aureus from mammary quarters of all positive cows were genotyped with RS-PCR, a technique based on amplification of a portion of the intergenic spacer 16S-23S rRNA, and a subset of 54 strains was also analyzed by multiplex PCR, ribotyping, PFGE, MLST, and spa typing. The RS-PCR analysis revealed 12 different profiles. Staphylococcus aureus strains isolated from 5 out of 8 HP herds showed a profile identical to the genotype B (GTB), described in previous studies as being strongly associated with high within-herd prevalence of Staph. aureus mastitis and the presence of the genes coding for enterotoxins sea, sed, and sej, a long x-region of spa gene, and 3 lukE fragments. Moreover, all strains isolated in the HP herds possessed genes coding for staphylococcal enterotoxins. In LP herds, a limited number of strains of 6 genotypes, different from those isolated in HP herds, were identified and GTB was not found. Within these genotypes, 4 strains were positive for the mecA gene. Preliminary results and comparison with other genotyping methods confirmed that genotyping by RS-PCR is an accurate, rapid, and inexpensive tool for future field studies on Staph. aureus mastitis strains and generates clinically relevant results.
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Affiliation(s)
- P Cremonesi
- Istituto di Biologia e Biotecnologia Agraria, CNR, via Einstein, 26900 Lodi, Italy
| | - F Pozzi
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia, Sezione di Lodi, via Einstein, 26900 Lodi, Italy
| | - M Raschetti
- Istituto di Biologia e Biotecnologia Agraria, CNR, via Einstein, 26900 Lodi, Italy
| | - G Bignoli
- Istituto di Biologia e Biotecnologia Agraria, CNR, via Einstein, 26900 Lodi, Italy
| | - E Capra
- Istituto di Biologia e Biotecnologia Agraria, CNR, via Einstein, 26900 Lodi, Italy
| | - H U Graber
- Agroscope, Institute for Food Sciences (IFS), Schwarzenburgstrasse 161, CH-3003, Bern, Switzerland
| | - F Vezzoli
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia, Sezione di Lodi, via Einstein, 26900 Lodi, Italy
| | - R Piccinini
- Dipartimento di Scienze Veterinarie e Sanità Pubblica, Università degli Studi di Milano, via Celoria, 20133 Milan, Italy
| | - B Bertasi
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia, Reparto Tecnologie Acidi Nucleici Applicate agli Alimenti, via Bianchi, 25124 Brescia, Italy
| | - S Biffani
- Istituto di Biologia e Biotecnologia Agraria, CNR, via Einstein, 26900 Lodi, Italy; Parco Tecnologico Padano, Via Einstein, 26900 Lodi, Italy
| | - B Castiglioni
- Istituto di Biologia e Biotecnologia Agraria, CNR, via Einstein, 26900 Lodi, Italy
| | - M Luini
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia, Sezione di Lodi, via Einstein, 26900 Lodi, Italy.
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Capranzano P, Castiglioni B. [The ISAR-SAFE study]. G Ital Cardiol (Rome) 2015; 16:331-5. [PMID: 26156693 DOI: 10.1714/1934.21024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Piera Capranzano
- Dipartimento Cardiovascolare, Ospedale Ferrarotto, Università degli Studi di Catania
| | - Battistina Castiglioni
- Cardiologia Interventistica, U.O. Cardiologia 2, Dipartimento Cardiovascolare, A.O. Ospedale di Circolo di Varese
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Lettieri C, Zavalloni D, Rossini R, Morici N, Ettori F, Leonzi O, Latib A, Ferlini M, Trabattoni D, Colombo P, Galli M, Tarantini G, Napodano M, Piccaluga E, Passamonti E, Sganzerla P, Ielasi A, Coccato M, Martinoni A, Musumeci G, Zanini R, Castiglioni B. Management and Long-Term Prognosis of Spontaneous Coronary Artery Dissection. Am J Cardiol 2015; 116:66-73. [PMID: 25937347 DOI: 10.1016/j.amjcard.2015.03.039] [Citation(s) in RCA: 201] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 03/17/2015] [Accepted: 03/17/2015] [Indexed: 12/15/2022]
Abstract
The optimal management and short- and long-term prognoses of spontaneous coronary artery dissection (SCAD) remain not well defined. The aim of this observational multicenter study was to assess long-term clinical outcomes in patients with SCAD. In-hospital and long-term outcomes were assessed in 134 patients with documented SCAD, as well as the clinical impact and predictors of a conservative rather than a revascularization strategy of treatment. The mean age was 52 ± 11, years and 81% of patients were female. SCAD presented as an acute coronary syndromes in 93% of patients. A conservative strategy was performed in 58% of patients and revascularization in 42%. On multivariate analysis, distal versus proximal or mid location of dissection (odds ratio 9.27) and basal Thrombolysis In Myocardial Infarction (TIMI) flow grade 2 or 3 versus 0 or 1 (odds ratio 0.20) were independent predictors of conservative versus revascularization strategy. A conservative strategy was associated with better in-hospital outcomes compared with revascularization (rates of major adverse cardiac events 3.8% and 16.1%, respectively, p = 0.028); however, no significant differences were observed in the long-term outcomes. In conclusion, in this large observational study of patients with SCAD, angiographic features significantly influenced the treatment strategy, providing an excellent short- and long-term prognosis.
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Affiliation(s)
| | - Dennis Zavalloni
- Department of Cardiology, Istituto Clinico Humanitas, Rozzano, Italy
| | - Roberta Rossini
- Department of Cardiology, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Nuccia Morici
- Department of Cardiology, Ospedale Niguarda, Milano, Italy
| | | | - Ornella Leonzi
- Department of Cardiology, Ospedale Poliambulanza, Brescia, Italy
| | - Azeem Latib
- Department of Cardiology, Istituto Scientifico San Raffaele, Milano, Italy
| | - Marco Ferlini
- Department of Cardiology, Policlinico S. Matteo, Pavia, Italy
| | | | - Paola Colombo
- Department of Cardiology, Ospedale Niguarda, Milano, Italy
| | - Mario Galli
- Department of Cardiology, Ospedale S. Anna, Como, Italy
| | | | | | | | | | - Paolo Sganzerla
- Department of Cardiology, Ospedale di Treviglio Caravaggio, Treviglio, Italy
| | - Alfonso Ielasi
- Department of Cardiology, Ospedale Mater Domini, Castellanza Italy
| | - Micol Coccato
- Department of Cardiology, Università di Padova, Padova, Italy
| | | | - Giuseppe Musumeci
- Department of Cardiology, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Roberto Zanini
- Department of Cardiology, Ospedale Carlo Poma, Mantova, Italy
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